Individual provider Active NPI

Kariean Smith, LPC-S

  • Professional Counselor
  • Brookhaven, MS
National Provider Identifier
1669067518
Registry record updated Mar 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
1300 Issued in MS
Practice address
113 Mississippi Ave
Brookhaven, MS 39601-4074
Phone
(662) 769-1022
NPI assigned
Mar 3, 2021
Last updated
Mar 3, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 1300 MS Primary

Addresses

Primary practice location

113 Mississippi Ave
Brookhaven, MS 39601-4074

Mailing address

113 Mississippi Ave
Brookhaven, MS 39601-4074
Phone (662) 769-1022

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251002002909 MS Practitioner - Mental Health Counselor 9537665161 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Uppal Medical Center LLCGroup PAC ID 4587998547, 129 clinicians
MDB Behavioral Health Services LLCGroup PAC ID 0749572915, 201 clinicians

Practice addresses (Care Compare)

1727 E Union St
Greenville, MS 38703-3253
Phone (662) 537-4830

1911 Mission
66 Suite B
Vicksburg, MS 39180-3762
Phone (601) 456-2598

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1300MSMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
MDB Care Management LLC CurrentSince Oct 1, 2025 Accepting new patients
Minor Med Care, LLC Current Accepting new patients
Uppal Medical Center LLC CurrentSince Oct 1, 2025 Accepting new patients
Minor Med Care, LLC CurrentSince Oct 1, 2025 Accepting new patients
MDB Behavioral Health Services LLC CurrentSince Nov 1, 2025 Accepting new patients
Sondermind Provider Network LLC Professional CurrentSince Sep 1, 2025 Accepting new patients

Locations

1727 E Union St
Greenville, MS 38703
Phone (662) 332-0373

215 Katherine Dr
#A
Jackson, MS 39232

2860 McDowell Road Ext
Jackson, MS 39204
Phone (601) 372-1117

1000 Highland Colony Pkwy
Ste 5203
Ridgeland, MS 39157
Phone (601) 427-4734

Organizations & group practices 6

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": "1614729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614729600000",
    "number": "1669067518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 MISSISSIPPI AVE",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396014074",
            "telephone_number": "662-769-1022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 MISSISSIPPI AVE",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396014074",
            "telephone_number": "662-769-1022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KARIEAN",
        "credential": "LPC-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-03",
        "last_updated": "2021-03-03",
        "certification_date": "2021-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MS",
            "license": "1300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookhaven, MS

Sources for this page

Verify at the official NPI Registry.