Individual provider Active NPI

Christine Annette Smothers, L.P.C.

  • Professional Counselor
  • Gulfport, MS
National Provider Identifier
1790799138
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0582 Issued in MS
Practice address
127 Gary St
Gulfport, MS 39503-3503
Phone
(228) 328-1202
Fax
(228) 328-2522
NPI assigned
Jul 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 0582 MS Primary

Addresses

Primary practice location

127 Gary St
Gulfport, MS 39503-3503

Mailing address

10723 Lilinoe Way
Diamondhead, MS 39525-4336
Phone (228) 255-3719

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20240126001729 MS Practitioner - Mental Health Counselor 6305299272 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

103 S 19TH Ave
Hattiesburg, MS 39401-6171
Phone (601) 544-4641

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Region 12 Commission on Mental Health & Retardation Pine Belt Men CurrentSince Jan 1, 2024 Accepting new patients
Region XII Commission CurrentSince Jan 1, 2024 Accepting new patients

Locations

103 S 19th Ave
Hattiesburg, MS 39401
Phone (601) 544-4222

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790799138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10723 LILINOE WAY",
            "city": "DIAMONDHEAD",
            "state": "MS",
            "postal_code": "395254336",
            "telephone_number": "228-255-3719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 GARY ST",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395033503",
            "telephone_number": "228-328-1202",
            "fax_number": "228-328-2522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMOTHERS",
        "first_name": "CHRISTINE",
        "middle_name": "ANNETTE",
        "credential": "L.P.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MS",
            "license": "0582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

Verify at the official NPI Registry.