Individual provider Active NPI

Anita Linnea Smith, MS, LPC, NCC

  • Professional Counselor
  • Mankato, MN
National Provider Identifier
1679840912
Registry record updated Oct 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
515 Issued in MN
Practice address
515 N Riverfront Dr
Suite 220
Mankato, MN 56001-3471
Phone
(800) 438-1772
Fax
(262) 345-5531
NPI assigned
Nov 30, 2011
Last updated
Oct 9, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2012

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 515 MN Primary

Addresses

Primary practice location

515 N Riverfront Dr
Suite 220
Mankato, MN 56001-3471

Mailing address

W175N11120 Stonewood Dr
Germantown, WI 53022-6511
Phone (262) 345-5560

Other identifiers 1

IdentifierTypeStateIssuer
515OtherMNLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20240102003732 MN Practitioner - Mental Health Counselor 1355791450 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
515MNMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Wisconsin Lutheran Child and Family Service Inc Professional CurrentSince Jan 1, 2024 Accepting new patients
Wisconsin Lutheran Child & Family Services Professional CurrentSince Jan 1, 2024 Accepting new patients
Wisconsin Lutheran Child & Family Service ,Inc. Past Accepting new patients
Wisconsin Lutheran Child & Family Service Professional Past Accepting new patients

Locations

44 Good Counsel Dr
Mankato, MN 56001
Phone (800) 438-1744

515 N Riverfront Dr
Ste 220
Mankato, MN 56001

700 Luther Dr
Mankato, MN 56001
Phone (507) 344-7406

W175N11120 Stonewood Dr
Germantown, WI 53022
Phone (262) 345-5533

Organizations & group practices 4

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": "1322611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349740800000",
    "number": "1679840912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W175N11120 STONEWOOD DR",
            "city": "GERMANTOWN",
            "state": "WI",
            "postal_code": "530226511",
            "telephone_number": "262-345-5560",
            "fax_number": "262-345-5531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 N RIVERFRONT DR",
            "address_2": "SUITE 220",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560013471",
            "telephone_number": "800-438-1772",
            "fax_number": "262-345-5531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ANITA",
        "middle_name": "LINNEA",
        "name_prefix": "Mrs.",
        "credential": "MS, LPC, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-30",
        "last_updated": "2012-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "515",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "515",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mankato, MN

Sources for this page

Verify at the official NPI Registry.