John M Smith, MSED, NCC, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

001528 Issued in IA

Practice address

933 E 53Rd St
Davenport, IA 52808

Phone

(563) 324-9309

NPI assigned

Oct 23, 2012

Sex

Male

Sole proprietor

No

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)

Enrolled

Practice roles

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.

• Lifeline Resources, LLC

  • Mental Health Counselor
  • Des Moines, IA
  • NPI 1073664694
  NPD (past)

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

{
    "created_epoch": "1350950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380067200000",
    "number": "1932452331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3125 DOUGLAS AVE STE 100",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503105310",
            "telephone_number": "563-324-9309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "933 E 53RD ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "52808",
            "telephone_number": "563-324-9309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JOHN",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "MSED, NCC, LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-23",
        "last_updated": "2013-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "001528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elisa Smith, M.D.
• Gregory V Smith, LISW
• Hannah Smith
• Janis Diane Smith, PH.D.
• Jillian Lynn Smith, DO
• Paul R Smith, DDS
• Reilly Smith
• Stanley S Smith, PH.D.
• Dustin Michael Smolenski, D.D.S
• Angela M Snyder, LISW

• Mental Health Counselor in Davenport, IA
• Providers in Davenport, IA by specialty
• Mental Health Counselor in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2013; 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.