Provider Demographics
NPI:1265175830
Name:PERDUE, CHONDRA ADELE (MS LPC LCPC LCDC NCC)
Entity type:Individual
Prefix:
First Name:CHONDRA
Middle Name:ADELE
Last Name:PERDUE
Suffix:
Gender:F
Credentials:MS LPC LCPC LCDC NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9490 FM 1960 BYPASS RD WEST
Mailing Address - Street 2:STE. 200 #287
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338
Mailing Address - Country:US
Mailing Address - Phone:346-777-5778
Mailing Address - Fax:
Practice Address - Street 1:9490 FM 1960 BYPASS RD W
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-4099
Practice Address - Country:US
Practice Address - Phone:346-777-5778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-20
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX52478101YA0400X
TX85973101YM0800X, 101YP2500X
NVCP5406-R101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty