Shannon Smith, LMHC-A

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

88000862A Issued in IN

Practice address

1406 E Joliet St
Crown Point, IN 46307-4724

Phone

(219) 736-8100

NPI assigned

Jan 11, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Abundant Living, Inc

  • Mental Health Counselor
  • Merrillville, IN
  • NPI 1679943955

  Mental Health

  NPD (past)

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

{
    "created_epoch": "1610323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610323200000",
    "number": "1326637786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9228 BIGGER ST",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464105926",
            "telephone_number": "908-370-7699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1406 E JOLIET ST",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463074724",
            "telephone_number": "219-736-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SHANNON",
        "credential": "LMHC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-11",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "88000862A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "CROWNPOINT",
            "affiliation": "Y",
            "affiliationName": "Trinity Counseling Resources",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CROWNPOINT",
            "address_1": "1406 Joliet Road",
            "city": "CROWN POINT",
            "state": "IN",
            "country_code": "US",
            "postal_code": "46307",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• David M. Smith, D.D.S.
• Dennis W Smith, D.P.M.
• Elizabeth Ellen Smith, APN, CNNP
• Joi Smith, RBT
• Meghan Anne Smith, COTA/L
• Sierra Smith
• Sydney Ellese Smith
• Valencia Smith
• Victoria Smith, RBT
• Zhane Smith, RBT

• All providers in Crown Point, IN
• Mental Health Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2021; 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.