Individual provider Active NPI

Gilbert A Smith, PH.D

  • Mental Health Counselor
  • Sicklerville, NJ
National Provider Identifier
1780745174
Registry record updated Dec 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
44SC01029400 Issued in NJ
Practice address
504 Sicklerville Rd
2ND. Floor
Sicklerville, NJ 08081-2626
Phone
(856) 728-4464
Fax
(856) 629-7468
NPI assigned
Dec 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2011

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 44SC01029400 NJ
Addiction (Substance Use Disorder) Counselor 101YA0400X 44SC01029400 NJ
Mental Health Counselor 101YM0800X 44SC01029400 NJ Primary
Professional Counselor 101YP2500X 44SC01029400 NJ
School Counselor 101YS0200X 44SC01029400 NJ

Addresses

Primary practice location

504 Sicklerville Rd
2ND. Floor
Sicklerville, NJ 08081-2626

Mailing address

PO Box 112
Sicklerville, NJ 08081-0112
Phone (856) 728-4464

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
44SC01029400NJMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Counselors, P.a. Counselor 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": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323820800000",
    "number": "1780745174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 112",
            "city": "SICKLERVILLE",
            "state": "NJ",
            "postal_code": "080810112",
            "telephone_number": "856-728-4464",
            "fax_number": "856-629-7468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 SICKLERVILLE RD",
            "address_2": "2ND. FLOOR",
            "city": "SICKLERVILLE",
            "state": "NJ",
            "postal_code": "080812626",
            "telephone_number": "856-728-4464",
            "fax_number": "856-629-7468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "GILBERT",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2011-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NJ",
            "license": "44SC01029400",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "44SC01029400",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "44SC01029400",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "44SC01029400",
            "primary": false
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "NJ",
            "license": "44SC01029400",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sicklerville, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2011; 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.