Provider Demographics
NPI:1881474286
Name:SMITH, STEPHANIE LYNNE (LPC-A)
Entity type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:LYNNE
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 1:9629 CROOKED CAT DR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75072-8954
Mailing Address - Country:US
Mailing Address - Phone:214-770-5163
Mailing Address - Fax:
Practice Address - Street 1:9629 CROOKED CAT DR
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75072-8954
Practice Address - Country:US
Practice Address - Phone:214-770-5163
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
TX91701101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor