Individual provider Active NPI

Will H Smith

  • Mental Health Counselor
  • Kalamazoo, MI
National Provider Identifier
1336920248
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
5725 Venture Park Dr Ste B
Kalamazoo, MI 49009-2816
Phone
(269) 459-8889
NPI assigned
Oct 9, 2023
Last updated
Oct 10, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

5725 Venture Park Dr Ste B
Kalamazoo, MI 49009-2816

Mailing address

70095 Green Pastures Rd
Sturgis, MI 49091-9736
Phone (269) 348-8938

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Willow Path Counseling Services CurrentSince Oct 15, 2023 Accepting new patients
Cornerstone Guardianship Services CurrentSince Oct 15, 2023 Accepting new patients

Locations

5725 Venture Park Dr
Ste B
Kalamazoo, MI 49009
Phone (269) 355-0725

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1696809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1336920248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70095 GREEN PASTURES RD",
            "city": "STURGIS",
            "state": "MI",
            "postal_code": "490919736",
            "telephone_number": "269-348-8938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5725 VENTURE PARK DR STE B",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490092816",
            "telephone_number": "269-459-8889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "WILL",
        "middle_name": "H",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-10-09",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; 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.