| Doctor Name: | JEANENE LEA SMITH |
| NPI Number: | 1184959363 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA, LPC, LMFT |
| License Number: | 64475 |
| Business Practice Address: | 1000 Westbank Dr Bldg 5a Suite 110 West Lake Hills, TX - 787466598 |
| Business Phone Number: | 5125788255 |
| Business Fax Number: | 5125970875 |
| Mailing Address: | 1000 Westbank Dr, Bldg 5a Suite 110 WEST LAKE HILLS |
| State: | TX |
| Postal Code: | 787466598 |
| Phone Number: | 5125788255 |
| Fax Number: | 5125970875 |
| NPI Enumeration Date: | 10/06/2009 |
| NPI Last Update Date: | 06/23/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 64475 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |