Provider Demographics
NPI:1831979301
Name:SMITH, MELISA ANN (LPC-A)
Entity type:Individual
Prefix:MS
First Name:MELISA
Middle Name:ANN
Last Name:SMITH
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5731 MONTCLAIR HILL LN
Mailing Address - Street 2:
Mailing Address - City:ROSHARON
Mailing Address - State:TX
Mailing Address - Zip Code:77583-2033
Mailing Address - Country:US
Mailing Address - Phone:713-591-0873
Mailing Address - Fax:
Practice Address - Street 1:5731 MONTCLAIR HILL LN
Practice Address - Street 2:
Practice Address - City:ROSHARON
Practice Address - State:TX
Practice Address - Zip Code:77583-2033
Practice Address - Country:US
Practice Address - Phone:713-591-0873
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-03
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX91055101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health