Kelly Atwater Smith

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC.0019511 Issued in CO

Practice address

12055 W 2ND PL
Lakewood, CO 80228-1506

Phone

(303) 425-0300

NPI assigned

Aug 27, 2015

Last updated

Feb 17, 2025By the provider in NPPES

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

Other names 1

• Kelly Marie Atwater Former name

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Jefferson Center for Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Wheat Ridge, CO
  • NPI 1154403798
  Medicare reassignment NPD
• Jefferson Center for Mental Health

  dba Blue Spruce Pharmacy

  • Community/Retail Pharmacy
  • Lakewood, CO
  • NPI 1861574642
  NPD

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

{
    "created_epoch": "1440633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739750400000",
    "number": "1366819195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4851 INDEPENDENCE ST",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800336715",
            "telephone_number": "303-425-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12055 W 2ND PL",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802281506",
            "telephone_number": "303-425-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KELLY",
        "middle_name": "ATWATER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-27",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "LPC.0019511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "ATWATER",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jessie Smith, RN
• Joey Smith, LPC
• Julie Hanna Smith, LMFT
• Julie Page-Kent Smith, RD
• Katherine Smith
• Ladeshadae Smith
• Lauren S Smith, MA, LPC
• Lindsay Patricia Smith, MA, BCBA
• Mallory Brooke Smith, M.A, LPCC
• Rachel Smith

• Professional Counselor in Lakewood, CO
• Providers in Lakewood, CO by specialty
• Professional Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.