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General NPI Number Information
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NPI Number | 1003244401
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Entity Type | Organization
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Legal Business Name | MICHELLE L. SMITH, MA, LPC
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Dates
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Enumeration Date | 10/22/2013
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Last Update Date | 10/22/2013
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Provider Practice Location Address
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Address Line | 15200 MOONLIGHT TRL
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City | CONROE
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State | TX
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Zip | 77384-3540
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Country | US
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Telephone | 936-648-6724
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Fax |
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Provider Business Mailing Address
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Address Line | 15200 MOONLIGHT TRL
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City | CONROE
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State | TX
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Zip | 77384-3540
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Country | US
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Telephone | 936-648-6724
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MICHELLE L SMITH
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Credential | LPC
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Telephone | 936-648-6724
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 63615
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License Number State | TX
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