Alice Smith, LMHC, CASAC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

000429 Issued in NY

Practice address

123 Pike St
Port Jervis, NY 12771-1824

Phone

(845) 856-7576

Fax

(845) 856-8231

NPI assigned

Aug 19, 2016

Sex

Female

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1471564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471564800000",
    "number": "1689129694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 PIKE ST",
            "city": "PORT JERVIS",
            "state": "NY",
            "postal_code": "127711824",
            "telephone_number": "845-856-7576",
            "fax_number": "845-856-8231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 PIKE ST",
            "city": "PORT JERVIS",
            "state": "NY",
            "postal_code": "127711824",
            "telephone_number": "845-856-7576",
            "fax_number": "845-856-8231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ALICE",
        "name_prefix": "Mrs.",
        "credential": "LMHC, CASAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-19",
        "last_updated": "2016-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "000429",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS OASAS",
            "identifier": "12588",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW YORK STATE OFFICE OF PROFESSIONS",
            "identifier": "000429",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gopal Shah, M.D.
• Sherry Kay Home Care, Inc.
• Christine Smallin, LCSW
• Leanorah Smickle, MSN PMHNP-BC
• Smile Zone Dentistry, Port Jervis PC
• Lawrence Edward Smith, LCSW
• Laura Soudant, CNS, LDN
• Janet M Spano, PHARM.D., R.PH
• Joseph J Spano, DC
• Amanda Springwaldt

• Mental Health Counselor in Port Jervis, NY
• Providers in Port Jervis, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.