Provider Demographics
NPI:1457461097
Name:SMITH, FREDA J (NCC, LPC)
Entity Type:Individual
Prefix:MS
First Name:FREDA
Middle Name:J
Last Name:SMITH
Suffix:
Gender:F
Credentials:NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 LAZY HOLLOW DR
Mailing Address - Street 2:#125A
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-2561
Mailing Address - Country:US
Mailing Address - Phone:713-817-0773
Mailing Address - Fax:
Practice Address - Street 1:2401 LAZY HOLLOW DR
Practice Address - Street 2:#125A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-2561
Practice Address - Country:US
Practice Address - Phone:832-388-4729
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2010-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health