Active NPI
Sara Jo Smith, LCP
- Psychologist
- El Dorado, KS
National Provider Identifier
1902408230
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 01521
- Practice address
- 1344 N Taylor St
El Dorado, KS 67042-3860 - Phone
- (620) 203-9077
- NPI assigned
- Nov 11, 2020
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 01521 | KS | Primary |
Addresses
Primary practice location
1344 N Taylor St
El Dorado, KS 67042-3860
Mailing address
1344 N Taylor St
El Dorado, KS 67042-3860
Phone (620) 203-9077
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 |
|---|---|---|---|
| 01521 | KS | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668902400000",
"number": "1902408230",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1344 N TAYLOR ST",
"city": "EL DORADO",
"state": "KS",
"postal_code": "670423860",
"telephone_number": "620-203-9077"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1344 N TAYLOR ST",
"city": "EL DORADO",
"state": "KS",
"postal_code": "670423860",
"telephone_number": "620-203-9077"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "SARA",
"middle_name": "JO",
"credential": "LCP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-11",
"last_updated": "2022-11-20",
"certification_date": "2022-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "KS",
"license": "01521",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Dorado, KS
- Christopher W Siwek, M. D.
- Danny E. Smiley Jr., LAT, ATC
- Caitlin Smith
- Christopher Allen Smith, O.D.
- James T Smith, LSCSW
- Allison J Sollo, M.D.
- South Central Mental Health Counseling Center
- South Central Mental Health Counseling Center Inc
- South Central Mental Health Counseling Center, Inc.
- South Central Mental Health Counseling Center, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.