Shannon Smith, PH.D.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0033 Issued in NV

Practice address

2520 Saint Rose Pkwy Ste 110
Henderson, NV 89074-7784

Phone

(725) 290-1238

NPI assigned

Jan 31, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Mindful Healing Counseling LLC

  • Mental Health Counselor
  • Las Vegas, NV
  • NPI 1558054775
  NPD
• Mindful Healing Counseling LLC

  • Addiction (Substance Use Disorder) Counselor
  • Las Vegas, NV
  • NPI 1659261055
  NPD
• Charleston Residential Services LLC

  • Substance Abuse Rehabilitation Facility
  • Las Vegas, NV
  • NPI 1790253060
  NPD (past)

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

{
    "created_epoch": "1327968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748044800000",
    "number": "1578835971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2520 SAINT ROSE PKWY STE 110",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890747784",
            "telephone_number": "725-290-1238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 SAINT ROSE PKWY STE 110",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890747784",
            "telephone_number": "725-290-1238"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4880 W University Ave Ste B2",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891033830",
            "country_code": "US",
            "telephone_number": "702-428-3500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SHANNON",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-01-31",
        "last_updated": "2025-05-24",
        "certification_date": "2025-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "0003348",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NV",
            "license": "CP0033",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NV",
            "license": "0033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mona Lese Cyre Smith
• Monique Smith
• Nubrittany Samone Smith
• Rachel Smith, PA-C
• Rebecca Rose Smith
• Stephen Javoil Smith II
• Steven Lee Smith, DPT
• Summer Ashland Smith
• Susan Schmitz Smith, DDS
• Tanner J Smith, PA-C

• Professional Counselor in Henderson, NV
• Providers in Henderson, NV by specialty
• Professional Counselor in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2025; 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.