Kristin Smith, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180-012576 Issued in IL

Practice address

520 N 4TH St
Springfield, IL 62702-5238

Phone

(217) 545-8000

Fax

(217) 757-8161

NPI assigned

Oct 8, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Bahn and Associates Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Springfield, IL
  • NPI 1932408929
  Medicare reassignment NPD

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

{
    "created_epoch": "1538956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582070400000",
    "number": "1427523356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E MADISON ST STE 300",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627025131",
            "telephone_number": "217-545-7885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 N 4TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627025238",
            "telephone_number": "217-545-8000",
            "fax_number": "217-757-8161"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2200 Lake Victoria Dr",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627035596",
            "country_code": "US",
            "telephone_number": "217-529-9266",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KRISTIN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-08",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "178012651",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178012651",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180-012576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kati Lynn Smith
• Kellsie Lynn Smith, RBT
• Kelly Lynn Smith, RN
• Kerri A Smith, ANP
• Kirby G Smith
• Lawrence J Smith, M.D.
• Matt R Smith
• Meagan Smith
• Richard L. Smith, M.D.
• Sarah Smith

• Professional Counselor in Springfield, IL
• Providers in Springfield, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.