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MR. EDWARD HAROLD PENDLETON MA, LPC, LCDC

Addiction Substance Use Disorder

Livingston, Texas

Provider NPI: 1265437495

Provider Information:
MR. EDWARD HAROLD PENDLETON MA, LPC, LCDC
Gender: M
Sole Proprietor


Practice Location:
2004 U S HIGHWAY 190 W  LIVINGSTON, TX 77351 US
Tel: 936-328-5880  Fax: 936-328-5883

Business Mailing Address:
PO BOX 1047  LIVINGSTON, TX 77351 US
Tel: 936-328-5880  Fax: 936-328-5883

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101Y00000XBehavioral Health & Social Service Providers
Counselor
TX17475

Other Provider Identifiers:

IssuerNumberStateType
AETNA7605707TX01
VALUE OPTIONS551895TX01
MAGELLAN719494000TX01
BLUECROSS/BLUESHIELD6088LCTX01
CAQH PROVIDER ID11451816TX01
1508236-01TX05
CIGNA BEHAVIORAL HEALTH2119098TX01
COMPCARE PROVIDER IDPENDL-0002TX01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







ADDICTION JOBS TX - Page 1

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