Provider Demographics
NPI:1902942915
Name:SMITH, GEORGIA PAULETTE (MA, LPC-SUPERVISOR)
Entity Type:Individual
Prefix:MS
First Name:GEORGIA
Middle Name:PAULETTE
Last Name:SMITH
Suffix:
Gender:F
Credentials:MA, LPC-SUPERVISOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 HILLS CREEK DR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-5231
Mailing Address - Country:US
Mailing Address - Phone:469-855-0256
Mailing Address - Fax:972-473-8052
Practice Address - Street 1:1475 RICHARDSON DR
Practice Address - Street 2:SUITE 230B
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-4659
Practice Address - Country:US
Practice Address - Phone:469-855-0256
Practice Address - Fax:972-473-8052
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2014-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX60839101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health