Provider Demographics
NPI:1285899153
Name:SMITH, DENISE (MED, LPC)
Entity type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18333 EGRET BAY BLVD
Mailing Address - Street 2:SUITE 540
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-3860
Mailing Address - Country:US
Mailing Address - Phone:832-864-6000
Mailing Address - Fax:832-864-6000
Practice Address - Street 1:18333 EGRET BAY BLVD STE 540
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-3266
Practice Address - Country:US
Practice Address - Phone:832-864-6000
Practice Address - Fax:832-864-6001
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-21
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX60737101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional