Frederick L Smoot, LMFT, PH. D.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

12959 Issued in CA

Practice address

30290 Ravenswood Cir
Murrieta, CA 92563-4808

Phone

(404) 695-5266

NPI assigned

Oct 11, 2006

Last updated

Sep 17, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Credentials

Doctor of Philosophy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mindshift Psychological Services Inc

  dba Mindshift Wellness Center

  • Marriage & Family Therapist
  • Corona, CA
  • NPI 1124656194

  Mental Health

  Medicare reassignment NPD

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631836800000",
    "number": "1982792057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30290 RAVENSWOOD CIR",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925634808",
            "telephone_number": "404-695-5266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30290 RAVENSWOOD CIR",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925634808",
            "telephone_number": "404-695-5266"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11731 Sterling Ave Ste B",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925034958",
            "country_code": "US",
            "telephone_number": "714-527-9700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMOOT",
        "first_name": "FREDERICK",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "LMFT, PH. D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "CA12959",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "12959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lezlie Renee Smith
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• Nakela Smith
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• Socal Foot Care PC (Socal Foot Care)
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• Mental Health Counselor in Murrieta, CA
• Providers in Murrieta, 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 Sep 17, 2021; 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.