Provider Demographics
NPI:1821743444
Name:SMILEY, KATELYN ALLYN (LCSW)
Entity Type:Individual
Prefix:
First Name:KATELYN
Middle Name:ALLYN
Last Name:SMILEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KATELYN
Other - Middle Name:ALLYN
Other - Last Name:HARLAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:4131 S BRAESWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025-3392
Mailing Address - Country:US
Mailing Address - Phone:713-986-7863
Mailing Address - Fax:
Practice Address - Street 1:4131 S BRAESWOOD BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77025-3392
Practice Address - Country:US
Practice Address - Phone:713-986-7863
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-14
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX654941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty