Mary Ellen Smith, MS,NCC,LPC-MH
Individual provider Active NPI Mental Health Counselor · Sioux Falls, SD
NPI 1720142730 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1720142730
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- LPC-MH 2148 (SD)
- Practice address
- 4400 W 69TH St
Sioux Falls, SD 57108-8170 - Phone
- (605) 322-4079
- Fax
- (605) 322-4060
- NPI assigned
- Dec 21, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Avera McKennan
Practice addresses (Care Compare)
2412 S Cliff Ave
Suite 200
Sioux Falls, SD 57105-4031
Phone (605) 322-4079
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SD
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240105003816 | SD | Practitioner - Mental Health Counselor | 8921459785 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC-MH 2148 | SD | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Avera McKennan | Current |
Accepting new patients | |
| Avera McKennan | Current | Accepting new patients | |
| Avera McKennan | Current |
Accepting new patients |
Locations
4400 W 69th St
Sioux Falls, SD 57108
Phone (605) 322-4005
3932 S Western Ave
Sioux Falls, SD 57105
Phone (605) 322-6408
Interoperability endpoints
- mary.smith@avera.sdhealthlink.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LPC-MH 2148 | SD | Yes |
Addresses
Primary practice location
4400 W 69TH St
Sioux Falls, SD 57108-8170
Mailing address
4400 W 69TH St
Sioux Falls, SD 57108-8170
Phone (605) 322-4079
Other providers in Sioux Falls, SD
- Kristine Carol Smith
- Lana J Smith
- Leslie Elizabeth Smith
- Makenzie Ruthann Smith
- Margaret A Smith
- Melissa Ann Smith
- Michael Craig Smith
- NA Smith
- Nichol W Smith
- Parker C Smith
All providers in Sioux Falls, SD · Mental Health Counselor in South Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.