Individual provider Active NPI

Shari Smith, MA, LPC, NCC

  • Professional Counselor
  • Port Huron, MI
National Provider Identifier
1780014464
Registry record updated Jan 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401013817 Issued in MI
Practice address
1423 Pine Grove Ave
Port Huron, MI 48060-3513
Phone
(810) 434-1400
Fax
(810) 479-9684
NPI assigned
Nov 18, 2013
Last updated
Jan 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2024

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 6401013817 MI Primary

Addresses

Primary practice location

1423 Pine Grove Ave
Port Huron, MI 48060-3513

Mailing address

1423 Pine Grove Ave
Port Huron, MI 48060-3513
Phone (810) 434-1400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20240301002332 MI Practitioner - Mental Health Counselor 6709221617 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3071 Commerce Dr
Suite B
Fort Gratiot, MI 48059-3869
Phone (810) 434-1400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
6401013817MIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Shari L. Smith PLLC Professional CurrentSince Jan 2, 2024 Accepting new patients
Changing Course Counseling, PLC Past Accepting new patients

Locations

3071 Commerce Dr
Ste B
Fort Gratiot, MI 48059
Phone (810) 357-9318

1423 Pine Grove Ave
Port Huron, MI 48060
Phone (810) 434-1400

Organizations & group practices 2

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": "1384732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704672000000",
    "number": "1780014464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1423 PINE GROVE AVE",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603513",
            "telephone_number": "810-434-1400",
            "fax_number": "810-479-9684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1423 PINE GROVE AVE",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603513",
            "telephone_number": "810-434-1400",
            "fax_number": "810-479-9684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SHARI",
        "credential": "MA, LPC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-18",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401013817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Huron, MI

Sources for this page

Verify at the official NPI Registry.