Provider Demographics
NPI:1770200867
Name:SMITH, MARSHA RACHELLE (MA, LPC)
Entity type:Individual
Prefix:
First Name:MARSHA
Middle Name:RACHELLE
Last Name:SMITH
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:MARSHA
Other - Middle Name:RACHELLE
Other - Last Name:CLINTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6 WASHINGTON CT
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76240-2438
Mailing Address - Country:US
Mailing Address - Phone:940-284-7792
Mailing Address - Fax:
Practice Address - Street 1:6 WASHINGTON CT
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:TX
Practice Address - Zip Code:76240-2438
Practice Address - Country:US
Practice Address - Phone:940-284-7792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-20
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX83919101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional