Provider Demographics
NPI:1518696939
Name:BROWN-SMITH, CAREN LYNETTE (LSSP, LPA)
Entity Type:Individual
Prefix:MRS
First Name:CAREN
Middle Name:LYNETTE
Last Name:BROWN-SMITH
Suffix:
Gender:F
Credentials:LSSP, LPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 82
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:TX
Mailing Address - Zip Code:76681-0082
Mailing Address - Country:US
Mailing Address - Phone:903-641-5127
Mailing Address - Fax:
Practice Address - Street 1:715 W 2ND AVE
Practice Address - Street 2:
Practice Address - City:CORSICANA
Practice Address - State:TX
Practice Address - Zip Code:75110-3012
Practice Address - Country:US
Practice Address - Phone:903-872-4442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-09
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15256103TC0700X
TX31192103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Single Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty