Provider Demographics
NPI:1871037580
Name:SMITH BARROW, LISA MICHELE
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:MICHELE
Last Name:SMITH BARROW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:MICHELE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:133 HILLSIDE DR
Mailing Address - Street 2:
Mailing Address - City:WHITNEY
Mailing Address - State:TX
Mailing Address - Zip Code:76692-7570
Mailing Address - Country:US
Mailing Address - Phone:221-448-6048
Mailing Address - Fax:
Practice Address - Street 1:133 HILLSIDE DR
Practice Address - Street 2:
Practice Address - City:WHITNEY
Practice Address - State:TX
Practice Address - Zip Code:76692-7570
Practice Address - Country:US
Practice Address - Phone:221-448-6048
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-14
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71968101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional