Provider Demographics
NPI:1649380643
Name:SMITH, DAWN L (LPC)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:L
Last Name:SMITH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:L
Other - Last Name:BRIDGES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:PO BOX 154437
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75915-4437
Mailing Address - Country:US
Mailing Address - Phone:936-639-3233
Mailing Address - Fax:936-639-3680
Practice Address - Street 1:600 S JOHN REDDITT DR
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904-3121
Practice Address - Country:US
Practice Address - Phone:936-639-3233
Practice Address - Fax:936-639-3680
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2024-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14973101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
83790LOtherBCBS
TX0278178-01Medicaid