Stephen William Smith, MS,LPC,CADC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

178.006369 Issued in IL

Practice address

1021 N Mulford Rd
Suite 1
Rockford, IL 61107-3877

Phone

(815) 708-4768

Fax

(815) 394-1401

NPI assigned

Apr 8, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1270684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276473600000",
    "number": "1326364845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 N MULFORD RD",
            "address_2": "SUITE 1",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611073877",
            "telephone_number": "815-708-4768",
            "fax_number": "815-394-1401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 N MULFORD RD",
            "address_2": "SUITE 1",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611073877",
            "telephone_number": "815-708-4768",
            "fax_number": "815-394-1401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "STEPHEN",
        "middle_name": "WILLIAM",
        "credential": "MS,LPC,CADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-04-08",
        "last_updated": "2010-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "25850",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.006369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Ann Smith, M.S. ED, ATC
• Meghan Smith
• Olivia Smith
• Rodney E Smith
• Shelby Smith, FNP-C
• Tombi Smith
• Clinton T Snedegar, M.D.
• SNH Lincoln Tenant LLC
• David Snow, LPC
• Dawn Lynn Snyder

• Professional Counselor in Rockford, IL
• Providers in Rockford, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2010; 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.