Active NPI
Marcia Mahan Smith, CASAC
- Addiction (Substance Use Disorder) Counselor
- Queens, NY
National Provider Identifier
1811294648
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 25596
- Practice address
- 104 70 Queens Boulevard
Suite 307
Queens, NY 11375 - Phone
- (718) 275-6010
- Fax
- (718) 275-6062
- NPI assigned
- Feb 14, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 25596 | NY | Primary |
Addresses
Primary practice location
104 70 Queens Boulevard
Suite 307
Queens, NY 11375
Mailing address
10470 Queens Blvd
Suite 307
Forest Hills, NY 11375-3638
Phone (718) 275-6010
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25596 | NY | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1297641600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1485302400000",
"number": "1811294648",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10470 QUEENS BLVD",
"address_2": "SUITE 307",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "113753638",
"telephone_number": "718-275-6010",
"fax_number": "718-275-6062"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "104 70 QUEENS BOULEVARD",
"address_2": "SUITE 307",
"city": "QUEENS",
"state": "NY",
"postal_code": "11375",
"telephone_number": "718-275-6010",
"fax_number": "718-275-6062"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAHAN SMITH",
"first_name": "MARCIA",
"credential": "CASAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-02-14",
"last_updated": "2017-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NY",
"license": "25596",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Queens, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.