Provider Demographics
NPI:1659853794
Name:HERRERA, PENNY ANN (LPC)
Entity Type:Individual
Prefix:MRS
First Name:PENNY
Middle Name:ANN
Last Name:HERRERA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1640 LAKESIDE ENCLAVE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-1687
Mailing Address - Country:US
Mailing Address - Phone:832-606-4807
Mailing Address - Fax:
Practice Address - Street 1:3007 CAROLINE ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-2822
Practice Address - Country:US
Practice Address - Phone:713-942-8100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-05
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64485101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional