Provider Demographics
NPI:1326626573
Name:SMITH, TRICIA KAY (LPC)
Entity Type:Individual
Prefix:
First Name:TRICIA
Middle Name:KAY
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 1:5845 HORTON ST STE 209
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66202-2610
Mailing Address - Country:US
Mailing Address - Phone:913-674-9302
Mailing Address - Fax:
Practice Address - Street 1:5845 HORTON ST STE 209
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:KS
Practice Address - Zip Code:66202-2610
Practice Address - Country:US
Practice Address - Phone:913-674-9302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-30
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional