NPIMap

Organization Active NPI

Karla Smith Foundation

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • O Fallon, IL
National Provider Identifier
1366923641
Registry record updated Aug 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
KARLA SMITH FOUNDATION
Practice address
200 N Lincoln Ave
O Fallon, IL 62269-1415
Phone
(618) 624-5771
Fax
(618) 206-6508
NPI assigned
Aug 24, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2018

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

Authorized official

Name
Mrs. Emily M Smith
Title
Executive Director
Phone
(618) 624-5771

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

200 N Lincoln Ave
O Fallon, IL 62269-1415

Mailing address

200 N Lincoln Ave
O Fallon, IL 62269-1415
Phone (618) 624-5771

Other names 1

  • Karla Smith Behavioral Health Doing business as

National Provider Directory

National Provider Directory

Locations

200 N Lincoln Ave
O Fallon, IL 62269
Phone (618) 624-5771

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1535068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1535068800000",
    "number": "1366923641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N LINCOLN AVE",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691415",
            "telephone_number": "618-624-5771",
            "fax_number": "618-206-6508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N LINCOLN AVE",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691415",
            "telephone_number": "618-624-5771",
            "fax_number": "618-206-6508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KARLA SMITH FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-24",
        "last_updated": "2018-08-24",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "EMILY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "618-624-5771",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Karla Smith Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Karla Smith Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in O Fallon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2018; 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.