Individual provider Active NPI

Kimberly K. Smith

  • Professional Counselor
  • Columbia, MO
National Provider Identifier
1568653913
Registry record updated Aug 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
SW003197 Issued in MO
Practice address
1200 E Broadway
Stephens College, Stamper Commons
Columbia, MO 65215-0001
Phone
(573) 876-7157
NPI assigned
Aug 8, 2007
Last updated
Aug 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2007

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X SW003197 MO
Addiction (Substance Use Disorder) Counselor 101YA0400X SW003197 MO
Mental Health Counselor 101YM0800X SW003197 MO
Professional Counselor 101YP2500X SW003197 MO Primary
School Counselor 101YS0200X SW003197 MO
Clinical Social Worker 1041C0700X SW003197 MO
School Social Worker 1041S0200X SW003197 MO
Marriage & Family Therapist 106H00000X SW003197 MO

Addresses

Primary practice location

1200 E Broadway
Stephens College, Stamper Commons
Columbia, MO 65215-0001

Mailing address

1200 E Broadway
Stephens College, Stamper Commons
Columbia, MO 65215-0001
Phone (573) 876-7157

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

State licenses

LicenseStateTypeSpecialty
SW003197MOMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1186531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186531200000",
    "number": "1568653913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 E BROADWAY",
            "address_2": "STEPHENS COLLEGE, STAMPER COMMONS",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652150001",
            "telephone_number": "573-876-7157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E BROADWAY",
            "address_2": "STEPHENS COLLEGE, STAMPER COMMONS",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652150001",
            "telephone_number": "573-876-7157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KIMBERLY",
        "middle_name": "K.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-08",
        "last_updated": "2007-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MO",
            "license": "SW003197",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MO",
            "license": "SW003197",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MO",
            "license": "SW003197",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "SW003197",
            "primary": true
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "MO",
            "license": "SW003197",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "SW003197",
            "primary": false
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "MO",
            "license": "SW003197",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MO",
            "license": "SW003197",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2007; 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.