Active NPI
Kimberlee J Smith Chiago, LPC
- Professional Counselor
- Surprise, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC-23186
- Practice address
- 15411 W Waddell Rd
Ste 102 PMB 1211
Surprise, AZ 85379-5170 - Phone
- (623) 239-3939
- Fax
- (480) 542-2239
- NPI assigned
- Jul 3, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC-23186 | AZ | Primary |
Addresses
Primary practice location
15411 W Waddell Rd
Ste 102 PMB 1211
Surprise, AZ 85379-5170
Mailing address
15411 W Waddell Rd
Ste 102 PMB 1211
Surprise, AZ 85379-5170
Phone (623) 239-3939
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
El Mirage, AZ 85335
Phone (623) 239-3939
11542 W Corrine Dr
El Mirage, AZ 85335-3948
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC-23186 | AZ | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| People Empowering People of Az Inc. | Current | Accepting new patients | |
| Grow Healthcare Group PA | Professional | Current | Accepting new patients |
| Desert Lakes Counseling LLC | Professional | Current | Accepting new patients |
| Mental Health Specialty Group PA | Professional | Current | Accepting new patients |
Locations
2066 W Apache Trl
Ste 101
Apache Junction, AZ 85120
Phone (480) 503-8530
4600 E Washington St
Ste 300
Phoenix, AZ 85034
Phone (602) 638-1872
2550 W Union Hills Dr
Phoenix, AZ 85027
Phone (602) 358-0224
15411 W Waddell Rd
Ste 102
Surprise, AZ 85379
Phone (325) 433-8485
66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Organizations & group practices 4
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- El Mirage, AZ
- NPI 1093506792
Professional
-
- Community/Behavioral Health Agency
- Apache Junction, AZ
- NPI 1801072590
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1719964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1761177600000",
"number": "1386480960",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15411 W WADDELL RD",
"address_2": "STE 102 PMB 1211",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "853795170",
"telephone_number": "623-239-3939",
"fax_number": "480-542-2239"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15411 W WADDELL RD",
"address_2": "STE 102 PMB 1211",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "853795170",
"telephone_number": "623-239-3939",
"fax_number": "480-542-2239"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH CHIAGO",
"first_name": "KIMBERLEE",
"middle_name": "J",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-07-03",
"last_updated": "2025-10-23",
"certification_date": "2025-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AZ",
"license": "LPC-23186",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Surprise, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.