Provider Demographics
NPI:1841068954
Name:SMITH-SHOEMO, AISHA NICHOLE (LPC-A)
Entity type:Individual
Prefix:
First Name:AISHA
Middle Name:NICHOLE
Last Name:SMITH-SHOEMO
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 1:2326 BRISTLEGRASS DR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-4548
Mailing Address - Country:US
Mailing Address - Phone:210-883-7198
Mailing Address - Fax:
Practice Address - Street 1:2225 COUNTY ROAD 90 STE 219
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-5111
Practice Address - Country:US
Practice Address - Phone:832-916-4416
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX93601101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional