Provider Demographics
NPI:1831142256
Name:SMITH, SHILAIN (PHD LPC)
Entity type:Individual
Prefix:MRS
First Name:SHILAIN
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:PHD LPC
Other - Prefix:
Other - First Name:SHILAIN
Other - Middle Name:
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:20702 WILD SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-7411
Mailing Address - Country:US
Mailing Address - Phone:404-641-7750
Mailing Address - Fax:
Practice Address - Street 1:4201 MEDICAL DR STE 330
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-5805
Practice Address - Country:US
Practice Address - Phone:210-614-4990
Practice Address - Fax:210-614-4991
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA5299101YM0800X
SC5167101YM0800X
LA6485101YP2500X
TX79127101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional