Provider Demographics
NPI:1508262296
Name:SMILEY, CHERYL (MED, LPC)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:SMILEY
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1714 10TH ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76301-5011
Mailing Address - Country:US
Mailing Address - Phone:940-766-4482
Mailing Address - Fax:940-766-4487
Practice Address - Street 1:1714 10TH ST
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76301-5011
Practice Address - Country:US
Practice Address - Phone:940-766-4482
Practice Address - Fax:940-766-4487
Is Sole Proprietor?:No
Enumeration Date:2014-11-07
Last Update Date:2014-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64290101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional