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Organization
DR GERALD W PENNIE
Active
Organization
DR GERALD W PENNIE
Active
Other names
Gerald Pennie
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GERALD WAYNE PENNIE PHD, LPC, NCC (LEAD COUNSELOR)
(713) 417-6057
Entity
Organization
Contact information
Practice address
3805 22ND ST STE 1C, LUBBOCK, TX 79410-1142
(713) 417-6057
(713) 417-6057
Mailing address
2735 GENOA AVE APT 2B, LUBBOCK, TX 79407-7848
(713) 417-6057
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
72286
TX
261QM0850X
Adult Mental Health Clinic/Center
72286
TX
261QM0855X
Adolescent and Children Mental Health Clinic/Center
72286
TX
Other
Enumeration date
05/31/2017
Last updated
08/07/2017
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