Provider Demographics
NPI:1962195388
Name:SMITH, RHONDA RENAE (LPC ASSOCIATE)
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:RENAE
Last Name:SMITH
Suffix:
Gender:F
Credentials:LPC ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 FOX DR
Mailing Address - Street 2:
Mailing Address - City:VIDOR
Mailing Address - State:TX
Mailing Address - Zip Code:77662-2210
Mailing Address - Country:US
Mailing Address - Phone:409-550-8444
Mailing Address - Fax:
Practice Address - Street 1:1650 FOX DR
Practice Address - Street 2:
Practice Address - City:VIDOR
Practice Address - State:TX
Practice Address - Zip Code:77662-2210
Practice Address - Country:US
Practice Address - Phone:409-550-8444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-31
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX88824101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor