Provider Demographics
NPI:1598529307
Name:SMITH, CAROLINE (MA, LPC-ASSOCIATE)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:MA, LPC-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5453 BURNET RD APT 133
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78756-1632
Mailing Address - Country:US
Mailing Address - Phone:706-442-8880
Mailing Address - Fax:
Practice Address - Street 1:5453 BURNET RD APT 133
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-1632
Practice Address - Country:US
Practice Address - Phone:706-442-8880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX94067101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health