Active NPI
Shelby Dionne Smith, LMFT
- Marriage & Family Therapist
- Algonquin, IL
National Provider Identifier
1295312809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 166001454
- Practice address
- 2220 Huntington Dr N
Algonquin, IL 60102-4419 - Phone
- (630) 229-2070
- NPI assigned
- Mar 28, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 166001454 | IL | Primary |
Addresses
Primary practice location
2220 Huntington Dr N
Algonquin, IL 60102-4419
Mailing address
2220 Huntington Dr N
Algonquin, IL 60102-4419
Phone (630) 229-2070
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 16, 2024 through Jan 16, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 166001454 | IL | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617062400000",
"number": "1295312809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2220 HUNTINGTON DR N",
"city": "ALGONQUIN",
"state": "IL",
"postal_code": "601024419",
"telephone_number": "630-229-2070"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2220 HUNTINGTON DR N",
"city": "ALGONQUIN",
"state": "IL",
"postal_code": "601024419",
"telephone_number": "630-229-2070"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "SHELBY",
"middle_name": "DIONNE",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-03-28",
"last_updated": "2021-03-30",
"certification_date": "2021-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Marriage & Family Therapist",
"state": "IL",
"license": "166001454",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Algonquin, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.