Individual provider Active NPI

Dallas Elden Smeltser Jr., LPC

  • Professional Counselor
  • Waco, TX
National Provider Identifier
1871719492
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
15625 Issued in TX
Practice address
1105 Jefferson Ave
Waco, TX 76701-1212
Phone
(254) 752-7889
NPI assigned
Apr 18, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 15625 TX Primary

Addresses

Primary practice location

1105 Jefferson Ave
Waco, TX 76701-1212

Mailing address

201 Ivy LN
Hewitt, TX 76643-3436

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240315001041 TX Practitioner - Mental Health Counselor 1557707254 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15625TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Heart of Texas Region MHMR Center CurrentSince Feb 4, 2024 Accepting new patients

Locations

110 S 12th St
Waco, TX 76701
Phone (254) 297-7124

1105 Jefferson Ave
Waco, TX 76701
Phone (254) 297-7000

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871719492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 IVY LN",
            "city": "HEWITT",
            "state": "TX",
            "postal_code": "766433436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 JEFFERSON AVE",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767011212",
            "telephone_number": "254-752-7889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMELTSER",
        "first_name": "DALLAS",
        "middle_name": "ELDEN",
        "name_suffix": "Jr.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "15625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

Verify at the official NPI Registry.