Provider Demographics
NPI:1083805808
Name:SMITH, REBECCA LENORA (LPC)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:LENORA
Last Name:SMITH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25335 BUDDE RD
Mailing Address - Street 2:1027
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77380-2200
Mailing Address - Country:US
Mailing Address - Phone:281-948-8768
Mailing Address - Fax:
Practice Address - Street 1:112 W PAULINE ST
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77301-1979
Practice Address - Country:US
Practice Address - Phone:936-760-1880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-07
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61098101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional