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MR. MICHAEL WAYNE SMITH- FERNANDEZ LCSW
NPI 1154788065
Counselor - Mental Health in Winston, OR

Active since January 22, 2016PECOS EnrolledAccepts Medicare Assignment
11 SW BRANTLEY DR, WINSTON, OR 97496(541) 679-0366(541) 679-4821 Get Directions Write a Review

NPPES record last updated: January 25, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jan 25, 2021, Mar 17, 2018, Jan 22, 2016 (3 updates tracked since 2016).

About Mr. Michael Wayne Smith- Fernandez Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. MICHAEL WAYNE SMITH- FERNANDEZ LCSW (NPI 1154788065) is an individual mental health provider in Winston, Oregon, licensed in Oregon (L10476) and active in the NPI registry since January 2016. He is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1154788065
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameMR. MICHAEL WAYNE SMITH- FERNANDEZCredential: LCSW
Location Address11 SW BRANTLEY DRWinston, OR 97496-4526
Mailing Address11 Sw Brantley DrWinston, OR 97496-4526 · (541) 679-0366 · Fax (541) 679-4821
Phone(541) 679-0366
Fax(541) 679-4821
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateJanuary 22, 2016
Last NPPES UpdateJanuary 25, 20213 updates tracked since enumeration
NPPES CertifiedJanuary 25, 2021
✔ NPI 1154788065 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in OR · L10476
11 SW BRANTLEY DR, Winston, OR 97496
Open in Google Maps ↗

Secondary Practice Locations 2

Location 13099 NE Diamond Lake BlvdRoseburg, OR 97470-3655 · Phone (541) 673-3469 ext. 1510
Location 21652 NW Hughwood CtRoseburg, OR 97471-8844 · Phone (541) 673-3985 ext. 401 · Fax (541) 673-8060

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Moda Health Plan, Inc., PacificSource Health Plans and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Michael Wayne Smith- Fernandez Lcsw is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9638583669
PECOS Enrollment IDI20210202001679
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

FUNCTIONAL MENTAL HEALTH LLC
Nurse Practitioner (Psychiatric/Mental Health)
11 SW BRANTLEY DR
WINSTON, OR 97496
Douglas County (541) 679-0366
PAZELY RACHELLE SPENCER PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
11 SW BRANTLEY DR
WINSTON, OR 97496
Douglas County (541) 679-0366
MRS. RHEA ANN BANDELIER CNP
Nurse Practitioner (Psychiatric/Mental Health)
11 SW BRANTLEY DR
WINSTON, OR 97496
Douglas County (541) 679-0366
ANN CAREY
Counselor (Mental Health)
11 SW BRANTLEY DR
WINSTON, OR 97496
Douglas County (541) 679-0366
STACY J NIELSEN, LCSW, LLC
Community/Behavioral Health
11 SW BRANTLEY DR
WINSTON, OR 97496
Douglas County (541) 679-0366
MS. LISA MARIE JENNINGS MSW,QMHP, CSWA, CADC
Counselor (Addiction (Substance Use Disorder))
11 SW BRANTLEY DR
WINSTON, OR 97496
Douglas County (541) 679-0366
NICK MARSHALL PCA
Counselor (Mental Health)
11 SW BRANTLEY DR
WINSTON, OR 97496
Douglas County (541) 679-0366

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Michael Smith- Fernandez's NPI number?

The NPI number for Michael Smith- Fernandez is 1154788065. It was assigned to this individual provider in the NPPES registry on January 22, 2016.

Where is Michael Smith- Fernandez located?

Michael Smith- Fernandez practices at 11 SW Brantley Dr, Winston, OR 97496. The listed phone number is (541) 679-0366.

What is Michael Smith- Fernandez's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Michael Smith- Fernandez enrolled in Medicare?

Yes. Michael Smith- Fernandez is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Michael Smith- Fernandez accept?

Health plans from BridgeSpan Health Company, Moda Health Plan, Inc., PacificSource Health Plans, Providence Health Plan and Regence BlueCross BlueShield of Oregon list Michael Smith- Fernandez as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Michael Smith- Fernandez was last updated on January 25, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.