Tanekia Danielle Smith, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

4198 Issued in AL

Practice address

129 E Park Cir
Birmingham, AL 35235-3000

Phone

(205) 836-7283

Fax

(205) 836-7824

NPI assigned

Dec 19, 2019

Sex

Female

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 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AL

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

Specialty

Mental Health Counselor

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eastside Mental Health Center IncGroup PAC ID 3577524362, 9 clinicians

Practice addresses (Care Compare)

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.

• Eastside Mental Health Center Inc

  • Community/Behavioral Health Agency
  • Birmingham, AL
  • NPI 1770637910
  Medicare reassignment Care Compare group NPD
• Eastside Mental Health Center

  • Counselor
  • Birmingham, AL
  • NPI 1023283421
  NPD (past)

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

{
    "created_epoch": "1576713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576713600000",
    "number": "1497393581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 E PARK CIR",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352353000",
            "telephone_number": "205-836-7283",
            "fax_number": "205-836-7824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 E PARK CIR",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352353000",
            "telephone_number": "205-836-7283",
            "fax_number": "205-836-7824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TANEKIA",
        "middle_name": "DANIELLE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-19",
        "last_updated": "2019-12-19",
        "certification_date": "2019-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AL",
            "license": "4198",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00000000",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD ALABAMA",
            "identifier": "00000000",
            "state": "AL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "URL",
            "affiliation": "N",
            "address_1": "129 E Park Cir",
            "city": "Birmingham",
            "state": "AL",
            "country_code": "US",
            "postal_code": "352353000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Staci Smith, LICSW
• Stancey Jane Smith, CRNP
• Stephanie Smith, MD
• Steven Craig Smith, MD
• Sydney Smith, PA-C
• Tedra Simmons Smith, DNP
• Terry Daniel Smith, M.D.
• Theolishia Vaughn Smith
• Thomas D Smith Jr., LMSW
• Thomas Eugene Smith

• Mental Health Counselor in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Mental Health Counselor in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 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.

Verify at the official NPI Registry.