NPIMap

Individual provider Active NPI

Erin Nicole Smith, LPC

  • Professional Counselor
  • Surprise, AZ
National Provider Identifier
1750892956
Registry record updated Oct 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC-16747 Issued in AZ
Practice address
14581 W Gelding Dr
Surprise, AZ 85379-5756
Phone
(480) 652-2301
NPI assigned
Oct 16, 2017
Last updated
Oct 16, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC-16747 AZ Primary

Addresses

Primary practice location

14581 W Gelding Dr
Surprise, AZ 85379-5756

Mailing address

14581 W Gelding Dr
Surprise, AZ 85379-5756
Phone (480) 652-2301

Other names 1

  • Erin Nicole Sullivan Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240108004290 AZ Practitioner - Mental Health Counselor 7810348471 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC-16747AZMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Amazing Journeys Counseling, LLC Current Accepting new patients
Teladoc Health Medical Group, P.a. Professional Current Accepting new patients
Tucson Psychiatry PLLC CurrentSince May 26, 2024 Accepting new patients
Making an Impact LLC Past Accepting new patients
Forge Ahead LLC Past Accepting new patients
Forge Ahead LLC Past Accepting new patients
Forge Ahead LLC Past Accepting new patients
Making an Impact LLC Past Accepting new patients
Making an Impact LLC Past Accepting new patients
Making an Impact LLC Past Accepting new patients

Locations

1500 N Wilmot Rd
Ste A200
Tucson, AZ 85712
Phone (520) 873-8562

Interoperability endpoints

  • Direct secure messaging: erinsmith@tdh.allscriptsdirect.net

Organizations & group practices 11

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

NPI Registry JSON

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

{
    "created_epoch": "1508112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508112000000",
    "number": "1750892956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14581 W GELDING DR",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853795756",
            "telephone_number": "480-652-2301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14581 W GELDING DR",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853795756",
            "telephone_number": "480-652-2301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ERIN",
        "middle_name": "NICOLE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-16",
        "last_updated": "2017-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC-16747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERIN",
            "last_name": "SULLIVAN",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Surprise, AZ

Sources for this page

Verify at the official NPI Registry.