Provider Demographics
NPI:1043713639
Name:SMART, DONNITA LASHAE (LCDC)
Entity type:Individual
Prefix:MRS
First Name:DONNITA
Middle Name:LASHAE
Last Name:SMART
Suffix:
Gender:F
Credentials:LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 E COLORADO BLVD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75203-1209
Mailing Address - Country:US
Mailing Address - Phone:214-946-5540
Mailing Address - Fax:214-946-7450
Practice Address - Street 1:123 E COLORADO BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75203-1209
Practice Address - Country:US
Practice Address - Phone:214-946-5540
Practice Address - Fax:214-946-7450
Is Sole Proprietor?:No
Enumeration Date:2018-03-09
Last Update Date:2018-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10531101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)