Provider Demographics
NPI:1184633232
Name:PRESTIGIOVANNI, CATHERINE PENICK (LPC - SUPERVISOR)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:PENICK
Last Name:PRESTIGIOVANNI
Suffix:
Gender:F
Credentials:LPC - SUPERVISOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2025 COUNTY RD 90, SUITE 201G
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584
Mailing Address - Country:US
Mailing Address - Phone:713-269-9117
Mailing Address - Fax:713-436-2557
Practice Address - Street 1:2025 COUNTY RD 90, SUITE 201G
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584
Practice Address - Country:US
Practice Address - Phone:713-269-9117
Practice Address - Fax:713-436-2557
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15260101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional