Jonathan Edward Smith

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

IMH22861 Issued in FL

Practice address

721 Ashley Dr
Crestview, FL 32536-9231

Phone

(850) 752-0448

NPI assigned

Jun 30, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1688083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1861179822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1014 EVERGLADE DR",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325783515",
            "telephone_number": "185-036-8414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 ASHLEY DR",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325369231",
            "telephone_number": "850-752-0448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JONATHAN",
        "middle_name": "EDWARD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-30",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH22861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jared Steven Sleeman, IDMT
• Sarah Slimski
• Kelly Smidebush, ARNP
• Alexa Smith, RBT
• Denise Anne Smith, M.D., PH.D.
• Kristina Smith, APRN
• Marilyn Ruth Smith, NP-C APRN
• Pamela Smith
• Solaris Counseling Services, LLC
• Barbara Southard

• Mental Health Counselor in Crestview, FL
• Providers in Crestview, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2023; 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.