Provider Demographics
NPI:1285459156
Name:SMITH, COLLIN CAREY (LPC)
Entity type:Individual
Prefix:
First Name:COLLIN
Middle Name:CAREY
Last Name:SMITH
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:844 SNAPDRAGON LN
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-2365
Mailing Address - Country:US
Mailing Address - Phone:972-896-2902
Mailing Address - Fax:
Practice Address - Street 1:5445 LEGACY DR STE 270
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-3363
Practice Address - Country:US
Practice Address - Phone:972-528-0009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX87402101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health