Individual provider Active NPI

Michael D Smith, LPC

  • Counselor
  • Greenville, SC
National Provider Identifier
1669410841
Registry record updated Oct 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
977 Issued in SC
Practice address
2094 Woodruff Rd
Greenville, SC 29607-5939
Phone
(864) 676-9211
Fax
(864) 676-9432
NPI assigned
Jun 2, 2006
Last updated
Oct 11, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 977 SC Primary

Addresses

Primary practice location

2094 Woodruff Rd
Greenville, SC 29607-5939

Mailing address

2094 Woodruff Rd
Greenville, SC 29607-5939
Phone (864) 676-9211

Other identifiers 1

IdentifierTypeStateIssuer
977OtherSCSC LIC #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20231208000055 SC Practitioner - Mental Health Counselor 7719336346 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Piedmont Psychiatric Service PAGroup PAC ID 1355245440, 12 clinicians

Practice addresses (Care Compare)

2094 Woodruff Rd
Greenville, SC 29607-5939
Phone (864) 676-9211

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
977SCMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Psychiatric Service PA CurrentSince Jan 1, 2024 Accepting new patients

Locations

2094 Woodruff Rd
Greenville, SC 29607
Phone (864) 676-9211

Organizations & group practices 1

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": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192060800000",
    "number": "1669410841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2094 WOODRUFF RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296075939",
            "telephone_number": "864-676-9211",
            "fax_number": "864-676-9432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2094 WOODRUFF RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296075939",
            "telephone_number": "864-676-9211",
            "fax_number": "864-676-9432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MICHAEL",
        "middle_name": "D",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2007-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "SC",
            "license": "977",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SC LIC #",
            "identifier": "977",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.