Individual provider Active NPI

Gwendolyn Smith

  • Mental Health Counselor
  • Westampton, NJ
National Provider Identifier
1710351754
Registry record updated Nov 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
S57783106456932 Issued in NJ
Practice address
770 Woodlane Rd
Westampton, NJ 08060-3804
Phone
(609) 267-5928
Fax
(609) 267-2318
NPI assigned
Nov 13, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X S57783106456932 NJ Primary

Addresses

Primary practice location

770 Woodlane Rd
Westampton, NJ 08060-3804

Mailing address

204 Brooke Ave
Magnolia, NJ 08049-1206

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
S57783106456932NJMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1447372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448236800000",
    "number": "1710351754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 BROOKE AVE",
            "city": "MAGNOLIA",
            "state": "NJ",
            "postal_code": "080491206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 WOODLANE RD",
            "city": "WESTAMPTON",
            "state": "NJ",
            "postal_code": "080603804",
            "telephone_number": "609-267-5928",
            "fax_number": "609-267-2318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "GWENDOLYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-13",
        "last_updated": "2015-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "S57783106456932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westampton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2015; 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.