BRYAN WILLIAM SMITH (LMFT) – Marriage & Family Therapist, NPI 1073802997

BRYAN WILLIAM SMITH (LMFT) is a healthcare provider. based in Kendallville, Indiana. specializing in MARRIAGE AND FAMILY THERAPIST. They hold the professional credentials LMFT. They hold a License No. 87000162A (IN). The NPI Number for BRYAN WILLIAM SMITH (LMFT) is 1073802997

Main info

Male
19 Years Of Experience
Accepts Medicare Assignment
Name
BRYAN WILLIAM SMITH (LMFT)
NPI
1073802997
Phone
(260) 347-4400
Address
1930 DOWLING ST.
Enumeration Date
31 March 2011
Last Update Date
11 April 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2604812718
Graduation Year
2007 (19 years ago)
PAC ID
8628595097
Group Practice PAC ID
5991794794
Professional Enrollment ID
I20250508002224
Address ID
IN468053458FO909XXBLVD400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience63
Completeness75
Years active:15State licenses:2Digital endpointsOther names

125 MARRIAGE AND FAMILY THERAPIST in IN

Provider Addresses for BRYAN WILLIAM SMITH (LMFT)

  • 1930 DOWLING ST.

    KENDALLVILLE, IN 46755

    Phone: (260) 347-4400

    Fax: (260) 347-3122

    Type: Mailing

  • 909 E STATE BLVD

    FORT WAYNE, IN 468053458

    Phone: (260) 481-2700

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-05-08

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250508002224IMarriage And Family TherapistINTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 46755)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5991794794View full group profile
NameSpecialtyState
Mental Health CounselorIN
Clinical Social WorkerIN
Nurse PractitionerIN
Family PracticeIN
-IN
-IN
-IN
Nurse PractitionerIN
Mental Health CounselorIN
Nurse PractitionerIN

Reviews

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Frequently asked questions

Can I verify BRYAN WILLIAM SMITH (LMFT) with an NPI only?
You can start verification with NPI 1073802997 for BRYAN WILLIAM SMITH (LMFT), then check state licensing separately.
Is BRYAN WILLIAM SMITH (LMFT) still practicing?
BRYAN WILLIAM SMITH (LMFT) is currently listed as active in the public NPI registry.
What is BRYAN WILLIAM SMITH (LMFT)'s primary classification?
Marriage & Family Therapist is the headline specialty for BRYAN WILLIAM SMITH (LMFT) here. Clinical services aligned with this taxonomy classification.
Where is BRYAN WILLIAM SMITH (LMFT) based?
BRYAN WILLIAM SMITH (LMFT) is tied to Kendallville, Indiana in the data we show; additional addresses may exist on the full record.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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