Provider Demographics
NPI:1346662640
Name:BISSING, PEGGY (LPC LCDC)
Entity Type:Individual
Prefix:
First Name:PEGGY
Middle Name:
Last Name:BISSING
Suffix:
Gender:F
Credentials:LPC LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18534 FORTY SIX PKWY
Mailing Address - Street 2:
Mailing Address - City:SPRING BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:78070-6876
Mailing Address - Country:US
Mailing Address - Phone:210-286-9334
Mailing Address - Fax:
Practice Address - Street 1:18534 FORTY SIX PKWY
Practice Address - Street 2:
Practice Address - City:SPRING BRANCH
Practice Address - State:TX
Practice Address - Zip Code:78070-6876
Practice Address - Country:US
Practice Address - Phone:210-286-9334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-06
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12065101YA0400X
TX67934101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)