Active NPI
Stanley George Smith, PH.D.
- Mental Health Counselor
- Moselle, MS
National Provider Identifier
1396971180
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 0496
- Practice address
- 1015 Terminal Dr
N/a
Moselle, MS 39459-9546 - Phone
- (601) 545-8006
- Fax
- (601) 545-1867
- NPI assigned
- Jun 7, 2009
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 0496 | MS | Primary |
Addresses
Primary practice location
1015 Terminal Dr
N/a
Moselle, MS 39459-9546
Mailing address
1015 Terminal Dr
N/a
Moselle, MS 39459-9546
Phone (601) 545-8006
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0496 | MS | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1244332800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1244332800000",
"number": "1396971180",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1015 TERMINAL DR",
"address_2": "N/A",
"city": "MOSELLE",
"state": "MS",
"postal_code": "394599546",
"telephone_number": "601-545-8006",
"fax_number": "601-545-1867"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1015 TERMINAL DR",
"address_2": "N/A",
"city": "MOSELLE",
"state": "MS",
"postal_code": "394599546",
"telephone_number": "601-545-8006",
"fax_number": "601-545-1867"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "STANLEY",
"middle_name": "GEORGE",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-06-07",
"last_updated": "2009-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MS",
"license": "0496",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moselle, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.