Provider Demographics
NPI:1821456880
Name:SMITH, JANE (MA, LPC, LMHC, CST)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:MA, LPC, LMHC, CST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 RICHMOND AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77006-5480
Mailing Address - Country:US
Mailing Address - Phone:832-878-2936
Mailing Address - Fax:
Practice Address - Street 1:1401 RICHMOND AVE STE 203
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-5480
Practice Address - Country:US
Practice Address - Phone:832-878-2936
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-05
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX202298106H00000X
TX70736101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist