Byron Smith Sr. Sr.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

PCCI2672 Issued in CA

Practice address

1770 E 118TH St
Los Angeles, CA 90059-2518

Phone

(323) 793-2375

NPI assigned

Feb 10, 2016

Last updated

Apr 16, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1455062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555372800000",
    "number": "1326407958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1770 E 118TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900592518",
            "telephone_number": "323-793-2375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1770 E 118TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900592518",
            "telephone_number": "323-793-2375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH SR.",
        "first_name": "BYRON",
        "name_suffix": "Sr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-02-10",
        "last_updated": "2019-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "PCCI2672",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7721",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1326407958",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Smith Integrative Licensed Clinical Social Worker Services, Inc.
• Sherene Smith Irving
• Smith Medical Management (Smith medical billing)
• Smith Medical Management (Smith Medical Billing)
• Smith Pharmacy Inc
• Heather Smith Wingren
• Tahira Ayanna Smith-Aifesehi, CRNA
• Donald Smith-Arizmendi, PHARMD
• Joseph Richard Smith-Lopez, MSW
• Paula Jean Smith-Marder, PH.D.

• Mental Health Counselor in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2019; 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.