Provider Demographics
NPI:1922200112
Name:PARDUE, KATHY (LPC)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:
Last Name:PARDUE
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 1:9950 CYPRESSWOOD DR # S.170
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-3414
Mailing Address - Country:US
Mailing Address - Phone:713-501-0663
Mailing Address - Fax:281-894-0141
Practice Address - Street 1:9950 CYPRESSWOOD DR # S.170
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-3414
Practice Address - Country:US
Practice Address - Phone:713-501-0663
Practice Address - Fax:281-894-0141
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17184101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7656397Medicare UPIN
TX514455Medicare UPIN
TX83904LMedicare UPIN
TX2272377Medicare UPIN