Shelly M Smith, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

1102-124 Issued in WI

Practice address

15300 Watertown Plank Rd Ste 106
Elm Grove, WI 53122-2348

Phone

(312) 635-4354

Fax

(888) 717-3028

NPI assigned

Nov 9, 2015

Last updated

Feb 2, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Beingg LLC

  dba Good Human Work

  • Mental Health Counselor
  • Minneapolis, MN
  • NPI 1558838300
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1447027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517529600000",
    "number": "1295108504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15300 WATERTOWN PLANK RD",
            "city": "ELM GROVE",
            "state": "WI",
            "postal_code": "531222300",
            "telephone_number": "312-635-4354",
            "fax_number": "888-717-3028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15300 WATERTOWN PLANK RD STE 106",
            "city": "ELM GROVE",
            "state": "WI",
            "postal_code": "531222348",
            "telephone_number": "312-635-4354",
            "fax_number": "888-717-3028"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "706 E Forrest Hill Ave",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "IL",
            "postal_code": "616031926",
            "country_code": "US",
            "telephone_number": "309-981-1015",
            "fax_number": "888-717-3028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SHELLY",
        "middle_name": "M",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-09",
        "last_updated": "2018-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": "166.001023",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WI",
            "license": "1102-124",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IN",
            "license": "35001994A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Serendipity Psychotherapy and Medication Management
• Shanti Mental Health Center LLC
• Theresa Marie Shuck, MS,MA,LCGC,LPC
• Kenneth A Sieczkowski, CADC-III
• Gary Frank Skaleski, LPC
• Mark G Snyder, PT
• Michael J. Sonney-Kamanski, RN
• Specialized Therapy Services LLC
• St Luk4Es Medical Center
• Trudy Steber, PHARM.D

• Marriage & Family Therapist in Elm Grove, WI
• Providers in Elm Grove, WI by specialty
• Marriage & Family Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.