Provider Demographics
NPI:1508656364
Name:SMITH, EVVIE
Entity type:Individual
Prefix:
First Name:EVVIE
Middle Name:
Last Name:SMITH
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4201 CYPRESS CREEK PKWY STE 169
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77068-3440
Mailing Address - Country:US
Mailing Address - Phone:832-855-0213
Mailing Address - Fax:
Practice Address - Street 1:4201 CYPRESS CREEK PKWY STE 169
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77068-3440
Practice Address - Country:US
Practice Address - Phone:832-855-0213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-07
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16586101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor