Active NPI
Patricia Smith, LMHP, CPC
- Mental Health Counselor
- Broken Bow, NE
National Provider Identifier
1821014697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 241
- Practice address
- 419 S 11TH Ave
Broken Bow, NE 68822-1907 - Phone
- (308) 872-6651
- NPI assigned
- Jul 14, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 241 | NE | Primary |
Addresses
Primary practice location
419 S 11TH Ave
Broken Bow, NE 68822-1907
Mailing address
42862 Callaway River Rd
Callaway, NE 68825-5102
Phone (308) 836-2645
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 |
|---|---|---|---|
| 241 | NE | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1821014697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "42862 CALLAWAY RIVER RD",
"city": "CALLAWAY",
"state": "NE",
"postal_code": "688255102",
"telephone_number": "308-836-2645"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "419 S 11TH AVE",
"city": "BROKEN BOW",
"state": "NE",
"postal_code": "688221907",
"telephone_number": "308-872-6651"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "PATRICIA",
"credential": "LMHP, CPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NE",
"license": "241",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Broken Bow, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.