Kimberley S Smith, LCDC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

11700 Issued in TX

Practice address

502 N Carver St
Midland, TX 79701-3634

Phone

(432) 570-3390

Fax

(432) 570-3375

NPI assigned

Feb 2, 2016

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

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.

• Permian Basin Community Center

  • Community/Behavioral Health Agency
  • Midland, TX
  • NPI 1013372374
  NPD (past)

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

{
    "created_epoch": "1454371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454371200000",
    "number": "1508224874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 N LOOP 250 W",
            "address_2": "APT 1122",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797035227",
            "telephone_number": "432-413-6228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 N CARVER ST",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797013634",
            "telephone_number": "432-570-3390",
            "fax_number": "432-570-3375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KIMBERLEY",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "LCDC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-02",
        "last_updated": "2016-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "11700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Geoffrey Smith, D.M.D.
• Erin Jensen Smith, M.S. CCC-SLP
• Jade Nicole Smith, LCSW
• Jena Nicole Smith
• Jo Denton Smith
• Monique Shavonne Smith, OTR-L
• Pamela J Smith, MS LPC
• Timothy Smithson, PA-S
• Katie Lynn Snapp, DDS
• Kandis R Snowden

• Addiction (Substance Use Disorder) Counselor in Midland, TX
• Providers in Midland, TX by specialty
• Addiction (Substance Use Disorder) Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2016; 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.