John Bradley Smith, PCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

E0003984 Issued in OH

Practice address

6825 N State Route 66
Defiance, OH 43512-6730

Phone

(419) 782-4196

NPI assigned

Aug 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Foundations Behavioral Health Services, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Celina, OH
  • NPI 1336118330
  NPD (past)

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430784000000",
    "number": "1477667046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8970",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436230970",
            "telephone_number": "419-782-4196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6825 N STATE ROUTE 66",
            "city": "DEFIANCE",
            "state": "OH",
            "postal_code": "435126730",
            "telephone_number": "419-782-4196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JOHN",
        "middle_name": "BRADLEY",
        "credential": "PCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2015-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E0003984",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1366526782",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Slattman, ATC
• Kayla Sloan, LPN
• Amber Smallman
• Deanna Smith
• Ella M Smith, LSW
• Malinda Lou Smith, OTR/L
• Monica Jane Smith, PCPNP
• Eric Snow
• Kylee Snyder
• Whitney Snyder, LMT

• Mental Health Counselor in Defiance, OH
• Providers in Defiance, OH by specialty
• Mental Health Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2015; 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.