Provider Demographics
NPI:1144869496
Name:SMEDLEY, DIANE (LPC)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:
Last Name:SMEDLEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 CAMBORN PL
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77384-4743
Mailing Address - Country:US
Mailing Address - Phone:407-739-7206
Mailing Address - Fax:
Practice Address - Street 1:10210 GROGANS MILL RD STE 193
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-1143
Practice Address - Country:US
Practice Address - Phone:832-934-4627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-04
Last Update Date:2020-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX79709101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health