Provider Demographics
NPI:1184215212
Name:SMITH, MIKEICIA DAWNAY (LCSW)
Entity Type:Individual
Prefix:
First Name:MIKEICIA
Middle Name:DAWNAY
Last Name:SMITH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7676 HILLMONT ST STE 344-23
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77040-6400
Mailing Address - Country:US
Mailing Address - Phone:713-853-9097
Mailing Address - Fax:
Practice Address - Street 1:7676 HILLMONT ST STE 344-23
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77040-6400
Practice Address - Country:US
Practice Address - Phone:713-853-9097
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-01
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX559861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical