Active NPI
Betty Jo Smith, LPC CACIII
- Professional Counselor
- Monument, CO
National Provider Identifier
1851353759
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2589
- Practice address
- 325 Second St
Monument, CO 80132-7935 - Phone
- (719) 487-1102
- Fax
- (719) 488-8103
- NPI assigned
- Apr 5, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 3528 | CO | |
| Professional Counselor | 101YP2500X | 2589 | CO | Primary |
Addresses
Primary practice location
325 Second St
Monument, CO 80132-7935
Mailing address
PO Box 1148
Monument, CO 80132-1148
Phone (719) 487-1102
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 082770 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240508000048 | CO | Practitioner - Mental Health Counselor | 1052752128 | Practice locations: Monument, CO |
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
325 2ND St
Suite H
Monument, CO 80132-9217
Phone (719) 487-1102
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2589 | CO | MD | Addiction (Substance Use Disorder) Counselor |
| 3528 | CO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1325030400000",
"number": "1851353759",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1148",
"city": "MONUMENT",
"state": "CO",
"postal_code": "801321148",
"telephone_number": "719-487-1102",
"fax_number": "719-488-8103"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "325 SECOND ST",
"city": "MONUMENT",
"state": "CO",
"postal_code": "801327935",
"telephone_number": "719-487-1102",
"fax_number": "719-488-8103"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "BETTY JO",
"credential": "LPC CACIII",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-04-05",
"last_updated": "2011-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CO",
"license": "3528",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CO",
"license": "2589",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "082770",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Monument, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.