James Antonio Smith, BSC, CADC II, ICADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

1140 Issued in GA

Practice address

669 Castlebottom Dr
Lawrenceville, GA 30045-2796

Phone

(518) 955-8868

NPI assigned

Dec 19, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1545177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545177600000",
    "number": "1669944260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "669 CASTLEBOTTOM DR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300452796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "669 CASTLEBOTTOM DR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300452796",
            "telephone_number": "518-955-8868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JAMES",
        "middle_name": "ANTONIO",
        "name_prefix": "Mr.",
        "credential": "BSC, CADC II, ICADC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-19",
        "last_updated": "2018-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "GA",
            "license": "1140",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THE ALCOHOL AND DRUG ABUSE CERTIFICATION BOARD OF GEORGIA, INC.",
            "identifier": "1140",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INTERNATIONAL CERTIFICATION & RECIPROCITY CONSORTIUM",
            "identifier": "806645",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hadley Marie Smith
• Harriett Virginia Smith
• Herschel Wellington Smith III, MD
• Irene Cheptoo Smith
• Ivania Smith
• James Lofton Smith Jr., M.D.
• Jason Kyle Smith, PT, DPT
• Jaylen Rhea Smith
• Jennifer W Smith, PA-C
• Jessica Faye Smith, APC

• Addiction (Substance Use Disorder) Counselor in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Addiction (Substance Use Disorder) Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2018; 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.