Individual provider Active NPI

Michael Gregory Smith II, MS, CDPT, CPC

  • Mental Health Counselor
  • Lynnwood, WA
National Provider Identifier
1750795852
Registry record updated Mar 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
5116 196TH St SW
Lynnwood, WA 98036-6148
Phone
(425) 776-1290
NPI assigned
Jun 17, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X CO60693284 WA
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

5116 196TH St SW
Lynnwood, WA 98036-6148

Mailing address

5406 79TH Ave NE
Marysville, WA 98270-8988
Phone (206) 602-0916

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
CO60693284WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Life Transitions L.L.C. Mental Health Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1402963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521417600000",
    "number": "1750795852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5406 79TH AVE NE",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982708988",
            "telephone_number": "206-602-0916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5116 196TH ST SW",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980366148",
            "telephone_number": "425-776-1290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MICHAEL",
        "middle_name": "GREGORY",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "MS, CDPT, CPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-17",
        "last_updated": "2018-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "CO60693284",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynnwood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2018; 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.