Active NPI
Charles Smith, LMHC
- Addiction (Substance Use Disorder) Counselor
- Mangonia Park, FL
National Provider Identifier
1568058378
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 18654
- Practice address
- 933 45TH St
Mangonia Park, FL 33407-2413 - Phone
- (561) 841-1000
- NPI assigned
- Dec 15, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 18654 | FL | Primary |
Addresses
Primary practice location
933 45TH St
Mangonia Park, FL 33407-2413
Mailing address
933 45TH St
Mangonia Park, FL 33407-2413
Phone (561) 841-1000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18654 | FL | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607990400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607990400000",
"number": "1568058378",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "933 45TH ST",
"city": "MANGONIA PARK",
"state": "FL",
"postal_code": "334072413",
"telephone_number": "561-841-1000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "933 45TH ST",
"city": "MANGONIA PARK",
"state": "FL",
"postal_code": "334072413",
"telephone_number": "561-841-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "CHARLES",
"name_prefix": "Mr.",
"credential": "LMHC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-12-15",
"last_updated": "2020-12-15",
"certification_date": "2020-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "FL",
"license": "18654",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mangonia Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2020; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.