Individual provider Active NPI

Jermia M Smith, LMHC MH16498

  • Mental Health Counselor
  • Riverview, FL
National Provider Identifier
1356805253
Registry record updated Jul 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH16498 Issued in FL
Practice address
10312 Bloomingdale Ave Ste 108-172
Riverview, FL 33578-3663
Phone
(813) 603-7473
NPI assigned
Jan 24, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2021

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 MH16498 FL Primary

Addresses

Primary practice location

10312 Bloomingdale Ave Ste 108-172
Riverview, FL 33578-3663

Mailing address

10312 Bloomingdale Ave Ste 108-172
Riverview, FL 33578-3663
Phone (813) 603-7473

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

State licenses

LicenseStateTypeSpecialty
MH16498FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Be Centre for Mental Health and Wellness LLC Mental Health CurrentSince Mar 1, 2020 Accepting new patients

Locations

138 E Bloomingdale Ave
Brandon, FL 33511
Phone (813) 444-7116

10312 Bloomingdale Ave
Ste 108172
Riverview, FL 33578
Phone (813) 603-7473

4316 New River Hills Pkwy
Valrico, FL 33596
Phone (813) 240-3948

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1548288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626393600000",
    "number": "1356805253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10312 BLOOMINGDALE AVE STE 108-172",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335783663",
            "telephone_number": "813-603-7473",
            "fax_number": "813-620-1101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10312 BLOOMINGDALE AVE STE 108-172",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335783663",
            "telephone_number": "813-603-7473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JERMIA",
        "middle_name": "M",
        "credential": "LMHC MH16498",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-24",
        "last_updated": "2021-07-16",
        "certification_date": "2021-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH16498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverview, FL

Sources for this page

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