Provider Demographics
NPI:1023535978
Name:PELOSI, ABBEY CHRISTINE (LCSW-S)
Entity Type:Individual
Prefix:
First Name:ABBEY
Middle Name:CHRISTINE
Last Name:PELOSI
Suffix:
Gender:F
Credentials:LCSW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1603 MEDICAL PKWY STE 320
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-7904
Mailing Address - Country:US
Mailing Address - Phone:512-827-8601
Mailing Address - Fax:512-872-5294
Practice Address - Street 1:1603 MEDICAL PKWY STE 320
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-7904
Practice Address - Country:US
Practice Address - Phone:512-827-8601
Practice Address - Fax:512-872-5294
Is Sole Proprietor?:No
Enumeration Date:2017-08-22
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX572081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical