Individual provider Active NPI

Charity Rae Josie Smith, LPC

  • Professional Counselor
  • Phoenix, AZ
National Provider Identifier
1437683059
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC-22439 Issued in AZ
Practice address
3033 N Central Ave Ste 700
Phoenix, AZ 85012-2806
Phone
(602) 230-7373
Fax
(602) 257-8029
NPI assigned
Apr 20, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Professional Counselor 101YP2500X LAC-18947 AZ
Professional Counselor 101YP2500X LPC-22439 AZ Primary

Addresses

Primary practice location

3033 N Central Ave Ste 700
Phoenix, AZ 85012-2806

Mailing address

3101 N Central Ave Ste 500
Phoenix, AZ 85012-2639
Phone (602) 230-7373

Other practice location 1

4425 E Agave Rd Ste 19
Phoenix, AZ 85044-0619
Phone (613) 127-6296

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240115001345 AZ Practitioner - Mental Health Counselor 3173975240 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LAC-18947AZMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Denova Collaborative Health, LLC Professional CurrentSince Jan 1, 2024 Accepting new patients
Denova Collaborative Health, LLC Current Accepting new patients
Denova Collaborative Health, LLC CurrentSince Jan 1, 2024 Accepting new patients

Locations

3033 N Central Ave
Ste 700
Phoenix, AZ 85012
Phone (602) 281-7289

3101 N Central Ave
Ste 500
Phoenix, AZ 85012

3101 N Central Ave
Ste 550
Phoenix, AZ 85012

3330 N 2nd St
Ste 601
Phoenix, AZ 85012
Phone (602) 234-3444

Organizations & group practices 3

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": "1492646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1437683059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 N CENTRAL AVE STE 500",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122639",
            "telephone_number": "602-230-7373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3033 N CENTRAL AVE STE 700",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122806",
            "telephone_number": "602-230-7373",
            "fax_number": "602-257-8029"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4425 E Agave Rd Ste 19",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850440619",
            "country_code": "US",
            "telephone_number": "613-127-6296",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CHARITY",
        "middle_name": "RAE JOSIE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-20",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LAC-18947",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC-22439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.