KD SMITH (NPI# 1235683855) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235683855 |
| Entity Type | Individual |
| Full Name | KD SMITH |
| Practice Address |
904 East Martin Luther King, Dr Centralia IL 62870 |
| Practice Telephone | 6185331391 |
| Mailing Telephone | 6185331391 |
| Enumeration Date | 2016-08-11 |
| Last Update Date | 2016-08-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 370915481007 | 05 |
| Street Address |
904 EAST MARTIN LUTHER KING, DR |
| City | CENTRALIA |
| State | IL |
| Zip Code | 62870 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093917569 | Odin Grade Sch 122 | Local Education Agency (LEA) | 100 Merritt, Odin, IL 62870-0250 | 2007-06-05 |
| 1902008477 | Odin Hs 700 | Local Education Agency (LEA) | 100 Merritt, Odin, IL 62870-0250 | 2007-06-05 |
| 1477674174 | Ssc Odin Operating Company LLC | Skilled Nursing Facility | 300 Green St, Odin, IL 62870-1062 | 2007-04-02 |
| 1669023313 | Cheryl T Merchant | Speech-Language Pathologist | 300 Green St, Odin, IL 62870-1062 | 2019-09-24 |
| 1790335479 | Christilyn Wacker | Physical Therapy Assistant | 300 Green St, Odin, IL 62870-1062 | 2019-09-16 |
| 1285284000 | Brittany Leight Shuler | Physical Therapy Assistant | 300 Green St, Odin, IL 62870-1062 | 2019-09-13 |
| 1700435757 | Kathy L Reynolds | Occupational Therapy Assistant | 300 Green St, Odin, IL 62870-1062 | 2019-09-11 |
| 1265081277 | Tisha Jo Rueter | Occupational Therapy Assistant | 300 Green St, Odin, IL 62870-1062 | 2019-09-11 |
| 1497304448 | Janie Sue Zimmerman | Occupational Therapy Assistant | 300 Green St, Odin, IL 62870-1062 | 2019-09-11 |
| 1588211395 | Kaylee Beth Heinzmann | Speech-Language Pathologist | 300 Green St, Odin, IL 62870-1062 | 2019-08-26 |
| Find all providers in zip 62870 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790385821 | Joshua Bigner | Counselor | 201 S Tower Ave Apt E2, Centralia, WA 98531-4055 | 2020-10-28 |
| 1356996151 | Matthew Crawford | Counselor | 904 E Martin Luther King Dr, Centralia, IL 62801 | 2019-08-08 |
| 1588130314 | Kennah White | Counselor | 904 E. Mlk Drive, Centralia, IL 62801 | 2018-10-19 |
| 1245721588 | Lindsey Nicole Fogliasso | Counselor | 904 East Mlk Dr., Centralia, IL 62801 | 2018-05-22 |
| 1376078246 | Ashley Patrice Broussard | Counselor | 1723 Kresky Ave, Centralia, WA 98531-8985 | 2017-04-27 |
| 1376082685 | Athena A Smith | Counselor | 904 E. Martin Luther King Dr, Centralia, IL 62801 | 2017-02-20 |
| 1023552551 | Kelsey Dulle | Counselor | 904 Martin Luther King Drive, Centralia, IL 62801-3058 | 2016-12-19 |
| 1548703580 | Tiana Barbee | Counselor | 904 Mlk Drive, Centralia, IL 62801-3058 | 2016-11-23 |
| 1518411131 | Shelia Wilson | Counselor | 904 E. Martin Luther King, Centralia, IL 62801-3058 | 2016-08-11 |
| 1447704069 | Meghan Branch | Counselor | 904 Martin Luther King Dr, Centralia, IL 62801 | 2016-08-11 |
| Find all providers in CENTRALIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.