Individual provider Active NPI

Maurice Allan Smith

  • Counselor
  • Columbus, OH
National Provider Identifier
1972012169
Registry record updated May 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
C.1901840 Issued in OH
Practice address
16 W Long St
Columbus, OH 43215-2815
Phone
(614) 225-0990
NPI assigned
Sep 20, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X C.1901840 OH Primary

Addresses

Primary practice location

16 W Long St
Columbus, OH 43215-2815

Mailing address

16 W Long St
Columbus, OH 43215-2815
Phone (614) 225-0990

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20241118001202 OH Practitioner - Mental Health Counselor 4688108335 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C.1901840OHMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast, Inc CurrentSince Sep 7, 2024 Accepting new patients
Southeast, Inc CurrentSince Sep 7, 2024 Accepting new patients

Locations

16 W Long St
Columbus, OH 43215

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1505865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682985600000",
    "number": "1972012169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 W LONG ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432152815",
            "telephone_number": "614-225-0990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 W LONG ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432152815",
            "telephone_number": "614-225-0990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MAURICE",
        "middle_name": "ALLAN",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-20",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OH",
            "license": "C.1901840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.