Active NPI
Sarah Smith
- Mental Health Counselor
- Lakeland, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- IMH11175
- Practice address
- 715 N Lake Ave
Lakeland, FL 33801-1908 - Phone
- (863) 519-0575
- NPI assigned
- May 12, 2014
- Sex
- Female
- 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 | IMH11175 | FL | Primary |
Addresses
Primary practice location
715 N Lake Ave
Lakeland, FL 33801-1908
Mailing address
PO Box 1559
Bartow, FL 33831-1559
Phone (863) 519-0575
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1835 Gilmore Ave
Lakeland, FL 33805-3017
Phone (863) 519-0575
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IMH11175 | FL | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peace River Center for Personal Development Inc | Current | Accepting new patients | |
| Cotler Healthcare & Development Inc. | Current | Accepting new patients | |
| Peace River Center for Personal Development Inc | Past | Accepting new patients |
Locations
901 S 62nd Ave
Hollywood, FL 33023
Phone (954) 893-0109
9835 Lake Worth Rd
Ste 16179
Lake Worth, FL 33467
1831 Gilmore Ave
Lakeland, FL 33805
Phone 8635190575 ext. 6494
1825 Gilmore Ave
Lakeland, FL 33805
Phone (863) 248-3300
1835 Gilmore Ave
Lakeland, FL 33805
Phone (863) 248-3300
715 N Lake Ave
Lakeland, FL 33801
Phone (863) 413-2566
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Bartow, FL
- NPI 1821097767
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Wellington, FL
- NPI 1225075047
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Lakeland, FL
- NPI 1538802939
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1399852800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574208000000",
"number": "1457762551",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1559",
"city": "BARTOW",
"state": "FL",
"postal_code": "338311559",
"telephone_number": "863-519-0575"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "715 N LAKE AVE",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338011908",
"telephone_number": "863-519-0575"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "SARAH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-05-12",
"last_updated": "2019-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "IMH11175",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lakeland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2019; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.