Individual provider Active NPI

Terrence T Smith, LPCC'S

  • Professional Counselor
  • Canton, OH
National Provider Identifier
1396894556
Registry record updated Jul 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E0002848 Issued in OH
Practice address
624 Market Ave N
Canton, OH 44702-1017
Phone
(330) 493-4553
Fax
(330) 493-3761
NPI assigned
Jan 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X E0002848 OH Primary

Addresses

Primary practice location

624 Market Ave N
Canton, OH 44702-1017

Mailing address

624 Market Ave N
Canton, OH 44702-1017
Phone (330) 493-4553

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E0002848OHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Rising Behavioral Healthcare and Recovery, Inc CurrentSince Aug 1, 2024 Accepting new patients
Phoenix Rising Behavioral Healthcare and Recovery Inc CurrentSince Aug 1, 2024 Accepting new patients

Locations

624 Market Ave N
Canton, OH 44702
Phone (330) 454-7066

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627603200000",
    "number": "1396894556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 MARKET AVE N",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447021017",
            "telephone_number": "330-493-4553",
            "fax_number": "330-493-3761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 MARKET AVE N",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447021017",
            "telephone_number": "330-493-4553",
            "fax_number": "330-493-3761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TERRENCE",
        "middle_name": "T",
        "name_prefix": "Mr.",
        "credential": "LPCC'S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2021-07-30",
        "certification_date": "2021-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E0002848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.