Individual provider Active NPI

Kenneth Smith, MA, LPCC

  • Professional Counselor
  • Columbus, OH
National Provider Identifier
1487105144
Registry record updated Mar 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E1800883 Issued in OH
Practice address
4041 N High St Ste 300N
Columbus, OH 43214-3200
Phone
(614) 209-0428
Fax
(614) 437-1554
NPI assigned
Oct 18, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X E1800883 OH Primary

Addresses

Primary practice location

4041 N High St Ste 300N
Columbus, OH 43214-3200

Mailing address

4041 N High St Ste 300N
Columbus, OH 43214-3200
Phone (614) 209-0428

Other identifiers 1

IdentifierTypeStateIssuer
0332591MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20250321000412 OH Practitioner - Mental Health Counselor 6305368184 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4041 N High St
Suite 300NN
Columbus, OH 43214-3247
Phone (614) 340-1578

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
E1800883OHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Autism, Assertiveness & Social Skills (Caass) LTD Counselor CurrentSince Mar 20, 2025 Accepting new patients
HMT LTD - Healthy Mind Training Professional CurrentSince Mar 11, 2025 Accepting new patients

Locations

4041 N High St
Ste 300N
Columbus, OH 43214
Phone (614) 209-0428

4041 N High St
Ste 300NN
Columbus, OH 43214
Phone (614) 209-0428

Organizations & group practices 2

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": "1476748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1487105144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4041 N HIGH ST STE 300N",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432143200",
            "telephone_number": "614-209-0428",
            "fax_number": "614-437-1554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4041 N HIGH ST STE 300N",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432143200",
            "telephone_number": "614-209-0428",
            "fax_number": "614-437-1554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KENNETH",
        "credential": "MA, LPCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-18",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E1800883",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0332591",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.