Provider Demographics
NPI:1447942461
Name:SMITH, LAYNE (LPC)
Entity type:Individual
Prefix:MRS
First Name:LAYNE
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:LAYNE
Other - Middle Name:
Other - Last Name:CALLIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 286
Mailing Address - Street 2:
Mailing Address - City:HALLSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75650-0286
Mailing Address - Country:US
Mailing Address - Phone:903-668-2173
Mailing Address - Fax:
Practice Address - Street 1:7345 U.S. 80
Practice Address - Street 2:
Practice Address - City:HALLSVILLE
Practice Address - State:TX
Practice Address - Zip Code:75650-0286
Practice Address - Country:US
Practice Address - Phone:903-668-2173
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-26
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81167101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional