Provider Demographics
NPI:1427470707
Name:SMITH, TATIANA N (LPC-S)
Entity type:Individual
Prefix:
First Name:TATIANA
Middle Name:N
Last Name:SMITH
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 LANCASHIRE LN
Mailing Address - Street 2:
Mailing Address - City:PROSPER
Mailing Address - State:TX
Mailing Address - Zip Code:75078-5650
Mailing Address - Country:US
Mailing Address - Phone:214-679-5519
Mailing Address - Fax:
Practice Address - Street 1:4645 AVON LN STE 270
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-1609
Practice Address - Country:US
Practice Address - Phone:469-777-8156
Practice Address - Fax:972-586-7032
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-06
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68913101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional