Individual provider Active NPI

Jasmine Janea Smith

  • Mental Health Counselor
  • Concord, NC
National Provider Identifier
1689035065
Registry record updated May 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
A18736 Issued in NC
Practice address
280 Executive Park Dr Ste 100
Concord, NC 28025-1838
Phone
(704) 237-4240
NPI assigned
Mar 14, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Other Technician 247200000X
Mental Health Counselor 101YM0800X A18736 NC Primary

Addresses

Primary practice location

280 Executive Park Dr Ste 100
Concord, NC 28025-1838

Mailing address

280 Executive Park Dr Ste 100
Concord, NC 28025-1838
Phone (704) 237-4240

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
A18736NCMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1457913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683244800000",
    "number": "1689035065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 EXECUTIVE PARK DR STE 100",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280251838",
            "telephone_number": "704-237-4240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 EXECUTIVE PARK DR STE 100",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280251838",
            "telephone_number": "704-237-4240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JASMINE",
        "middle_name": "JANEA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-14",
        "last_updated": "2023-05-05",
        "certification_date": "2023-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A18736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2023; 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.