Individual provider Active NPI

Carlton Smith, LCDC

  • Addiction (Substance Use Disorder) Counselor
  • Longview, TX
National Provider Identifier
1407652548
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
8535 Issued in TX
Practice address
201 Pine Tree Rd
Longview, TX 75604-4140
Phone
(903) 759-4966
NPI assigned
Feb 20, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 8535 TX Primary

Addresses

Primary practice location

201 Pine Tree Rd
Longview, TX 75604-4140

Mailing address

201 Pine Tree Rd
Longview, TX 75604-4140
Phone (903) 759-4966

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

State licenses

LicenseStateTypeSpecialty
8535TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
East Texas Clinic Inc CurrentSince Feb 23, 2025 Accepting new patients

Locations

201 Pine Tree Rd
Longview, TX 75604
Phone (903) 759-4966

Organizations & group practices 1

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": "1740009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1407652548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 PINE TREE RD",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756044140",
            "telephone_number": "903-759-4966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 PINE TREE RD",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756044140",
            "telephone_number": "903-759-4966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CARLTON",
        "credential": "LCDC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-02-20",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "8535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2025; 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.