Provider Demographics
NPI:1699447227
Name:SMITH, SYLVIA J (MED LPC-A)
Entity type:Individual
Prefix:
First Name:SYLVIA
Middle Name:J
Last Name:SMITH
Suffix:
Gender:F
Credentials:MED LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8703 MEADOWCROFT DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-5006
Mailing Address - Country:US
Mailing Address - Phone:713-840-7957
Mailing Address - Fax:
Practice Address - Street 1:8703 MEADOWCROFT DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-5006
Practice Address - Country:US
Practice Address - Phone:713-840-7957
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-01
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX85881101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX85881OtherTEXAS BEHAVIORAL HEALTH EXECUTIVE COUNCIL