Carolyn Jeanne Smith, MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

27544 Issued in CA

Practice address

175 S Humboldt St
Willits, CA 95490-3511

Phone

(530) 570-4474

NPI assigned

Oct 19, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ms. Carrie Smith Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570752000000",
    "number": "1750463139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 S HUMBOLDT ST",
            "city": "WILLITS",
            "state": "CA",
            "postal_code": "954903511",
            "telephone_number": "530-570-4474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 S HUMBOLDT ST",
            "city": "WILLITS",
            "state": "CA",
            "postal_code": "954903511",
            "telephone_number": "530-570-4474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CAROLYN",
        "middle_name": "JEANNE",
        "name_prefix": "Ms.",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-19",
        "last_updated": "2019-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "27544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MFT",
            "identifier": "27544",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARRIE",
            "last_name": "SMITH",
            "prefix": "MS.",
            "credential": "MFT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Henrietta A Simonsson, RN
• Diane L Smalley, L.AC.
• Peter J. Smith
• Taya Smith
• Abbie Gayle Stephens, PPS
• Divora Wilma Stern, LCSW
• Stephanie Strickland, FNP-BC/C, RN, MSN

• Marriage & Family Therapist in Willits, CA
• Providers in Willits, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2019; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.