Provider Demographics
NPI:1851116693
Name:SMALT, ALYSSA JO (LPC)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:JO
Last Name:SMALT
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:ALYSSA
Other - Middle Name:JO
Other - Last Name:DUNCAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4189 STATE HIGHWAY 6 S
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-8965
Mailing Address - Country:US
Mailing Address - Phone:979-353-1161
Mailing Address - Fax:979-977-0666
Practice Address - Street 1:4189 STATE HIGHWAY 6 S
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845-8965
Practice Address - Country:US
Practice Address - Phone:979-353-1161
Practice Address - Fax:979-977-0666
Is Sole Proprietor?:No
Enumeration Date:2024-11-18
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional