Provider Demographics
NPI:1649609827
Name:SANTISTEVAN, PEI-FEN (LPC)
Entity type:Individual
Prefix:MRS
First Name:PEI-FEN
Middle Name:
Last Name:SANTISTEVAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MISS
Other - First Name:PEI-FEN
Other - Middle Name:
Other - Last Name:SU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:1020 RIVERWOOD CT
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-2811
Mailing Address - Country:US
Mailing Address - Phone:936-521-6301
Mailing Address - Fax:
Practice Address - Street 1:1020 RIVERWOOD CT
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-2811
Practice Address - Country:US
Practice Address - Phone:936-521-6301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-07
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67310101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional