Individual provider Active NPI

Veeda Jene Smalls, MA, LPC

  • Mental Health Counselor
  • Sumter, SC
National Provider Identifier
1568516508
Registry record updated Jun 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
2585 Issued in SC
Practice address
533 Oxford St
Suite D
Sumter, SC 29150-3353
Phone
(803) 775-5261
Fax
(803) 773-8111
NPI assigned
Jan 23, 2007
Last updated
Jun 7, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 2585 SC Primary

Addresses

Primary practice location

533 Oxford St
Suite D
Sumter, SC 29150-3353

Mailing address

PO Box 1627
Sumter, SC 29151-1627
Phone (803) 775-5261

Other identifiers 5

IdentifierTypeStateIssuer
228841OtherCOMPSYCH
717761000OtherMAGELLAN
GP3846MedicaidSC
11618685OtherCAQH
499995OtherVALUE OPTION

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
2585SCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
New Journey Counseling Services, LLC Mental Health Current Accepting new patients

Locations

533 Oxford St
Ste D
Sumter, SC 29150
Phone (803) 775-5261

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275868800000",
    "number": "1568516508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1627",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291511627",
            "telephone_number": "803-775-5261",
            "fax_number": "803-773-8111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "533 OXFORD ST",
            "address_2": "SUITE D",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291503353",
            "telephone_number": "803-775-5261",
            "fax_number": "803-773-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMALLS",
        "first_name": "VEEDA",
        "middle_name": "JENE",
        "name_prefix": "Mrs.",
        "credential": "MA, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2010-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "SC",
            "license": "2585",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMPSYCH",
            "identifier": "228841",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "717761000",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP3846",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11618685",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTION",
            "identifier": "499995",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sumter, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2010; 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.