David Smith, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6231-125 Issued in WI

Practice address

10900 67TH Street
Kenosha, WI 53142

Phone

(262) 914-7422

NPI assigned

Oct 6, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

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

Specialty

Mental Health Counselor

Education

Other, 2005

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Abg Wellness Group IncGroup PAC ID 0345536785, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Abg Wellness Group Inc

  • Community/Behavioral Health Agency
  • Milwaukee, WI
  • NPI 1184087389
  Medicare reassignment Care Compare group NPD
• Clearview Counseling Group

  • Community/Behavioral Health Agency
  • Kenosha, WI
  • NPI 1013449545
  NPD (past) Authorized official

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

{
    "created_epoch": "1475712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475712000000",
    "number": "1720538499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5439 DURAND AVE",
            "address_2": "SUITE 240B",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534065058",
            "telephone_number": "262-914-7422",
            "fax_number": "262-671-0016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10900 67TH STREET",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "53142",
            "telephone_number": "262-914-7422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DAVID",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-10-06",
        "last_updated": "2016-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "6231-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alec Samuel Small, DO
• Dennis Smerko, CPO, LPO
• Smile Doctors LTD
• Lisa Smith-Nowak, RN
• Abigail L Smith, LAT
• Elizabeth Mary Timm Smith, FNP
• Karen D Smith, APNP-BC
• Madeline Marie Smith
• Rachel M Smith, FNP
• Rochelle Smith

• Professional Counselor in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.