Charlotte M Smith, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

178.021313 Issued in IL

Practice address

1517 W Holly Hedges Dr
Peoria, IL 61614-4168

Phone

(847) 977-7647

NPI assigned

Jan 17, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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": "1737072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740096000000",
    "number": "1326859422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1517 W HOLLY HEDGES DR",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616144168",
            "telephone_number": "847-977-7647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1517 W HOLLY HEDGES DR",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616144168",
            "telephone_number": "847-977-7647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CHARLOTTE",
        "middle_name": "M",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-17",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.021313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexander Blake Smith
• Andrea Smith, RBT
• Bonnie Smith, M.D.
• Brooke Miranda Smith
• Cally J Smith, APN
• Christina A Smith, LCSW
• Courtney Lynn Smith, MD
• Danielle J Smith, MD
• Jeanne Frances Smith, MD
• Julie A Smith

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2025; 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.