Individual provider Active NPI

Brant Dean Smith, MFTI

  • Marriage & Family Therapist
  • San Bernardino, CA
National Provider Identifier
1497934996
Registry record updated Apr 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT51632 Issued in CA
Practice address
820 E Gilbert St
San Bernardino, CA 92415-0928
Phone
(909) 387-7200
Fax
(909) 387-7717
NPI assigned
Oct 31, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LMFT51632 CA Primary

Addresses

Primary practice location

820 E Gilbert St
San Bernardino, CA 92415-0928

Mailing address

820 E Gilbert St
San Bernardino, CA 92415-0928
Phone (909) 387-7200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20240612003078 CA Practitioner - Marriage and Family Therapist 1658813068 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spring to Autumn Family Counseling, Inc.Group PAC ID 1254773054, 18 clinicians

Practice addresses (Care Compare)

2068 Orange Tree LN
Suite 216
Redlands, CA 92374-4555
Phone (909) 557-6574

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMFT51632CAMDMarriage & Family Therapist
51632CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
County of San Bernardino CurrentSince Apr 13, 2024 Accepting new patients
County of San Bernardino CurrentSince Apr 13, 2024 Accepting new patients
Spring to Autumn Family Counseling, Inc. Marriage & Family Therapist CurrentSince Oct 1, 2024 Accepting new patients
County of San Bernardino Current Accepting new patients

Locations

1275 W Park Ave
#7461
Redlands, CA 92373

2068 Orange Tree Ln
Ste 216
Redlands, CA 92374
Phone (909) 553-0448

11870 Pierce St
Ste 150
Riverside, CA 92505
Phone (909) 557-6574

820 E Gilbert St
Sn Bernrdno, CA 92415

303 E Vanderbilt Way
Sn Bernrdno, CA 92415
Phone (909) 388-0801

Organizations & group practices 4

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": "1193788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430352000000",
    "number": "1497934996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 E GILBERT ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924150928",
            "telephone_number": "909-387-7200",
            "fax_number": "909-387-7717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 E GILBERT ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924150928",
            "telephone_number": "909-387-7200",
            "fax_number": "909-387-7717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BRANT",
        "middle_name": "DEAN",
        "name_prefix": "Mr.",
        "credential": "MFTI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-31",
        "last_updated": "2015-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT51632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.