Debra Grace Peterson-Smith, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

000946 Issued in NY

Practice address

7652 State Route 31
Bridgeport, NY 13030-8400

Phone

(315) 247-0816

NPI assigned

May 14, 2022

Last updated

May 14, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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": "1652486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652486400000",
    "number": "1871230581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7652 STATE ROUTE 31",
            "city": "BRIDGEPORT",
            "state": "NY",
            "postal_code": "130308400",
            "telephone_number": "315-247-0816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7652 STATE ROUTE 31",
            "city": "BRIDGEPORT",
            "state": "NY",
            "postal_code": "130308400",
            "telephone_number": "315-247-0816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON-SMITH",
        "first_name": "DEBRA",
        "middle_name": "GRACE",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-14",
        "last_updated": "2022-05-14",
        "certification_date": "2022-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "000946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "BetterHelp.com",
            "affiliation": "N",
            "endpointDescription": "Online therapy",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "online therapy",
            "address_1": "7652 State Route 31",
            "city": "Bridgeport",
            "state": "NY",
            "country_code": "US",
            "postal_code": "130308400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Linda Anne Lang, LPN
• Karen Janel Nash
• Beth P Norman, RN
• Lauren Elizabeth Ostrander, RN, NNP
• Kristy Lee Dracker Parkin
• Kim M Proper
• Kimberly Michele Sexton
• Jennifer E Street
• Syracuse DME LLC
• Timothy Walsh, R.PH.

• Mental Health Counselor in Bridgeport, NY
• Providers in Bridgeport, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2022; 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.