Kristie Ann Smith

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

90002 Issued in CA

Practice address

801 E Chapman Ave Ste 203
Fullerton, CA 92831-3846

Phone

(714) 680-9000

Fax

(714) 680-8233

NPI assigned

Apr 24, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Center for New Directions, Inc.

  • Mental Health Counselor
  • Laguna Hills, CA
  • NPI 1578121190
  Medicare reassignment NPD
• Sondermind Professional Clinical Counselor, PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1598629362
  Medicare reassignment
• Crittenton Services

  • Case Management Agency
  • Fullerton, CA
  • NPI 1699143545
  NPD (past)
• Stephen M Pumphrey Licensed Clinical Social Workers Inc

  • Clinical Social Worker
  • Laguna Hills, CA
  • NPI 1386862969
  NPD (past)

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

{
    "created_epoch": "1556064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562803200000",
    "number": "1912561911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 919",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928360919",
            "telephone_number": "714-680-9000",
            "fax_number": "714-680-8233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 E CHAPMAN AVE STE 203",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928313846",
            "telephone_number": "714-680-9000",
            "fax_number": "714-680-8233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KRISTIE",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-24",
        "last_updated": "2019-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "90002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colin Gregory Smith II
• Delaney Smith, OTD, OTR/L
• Grayson Smith
• Jamie Andrea Smith
• Jessica A Smith, MSTC
• Leekeisha Hardelle Smith
• Levi Smith
• Marie Patricia Smith, B.A.
• Paresha Shalay Smith
• Robina Michelle Smith, M.D.

• Mental Health Counselor in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.