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Individual
MR. EDWARD HAROLD PENDLETON
Active
Individual
MR. EDWARD HAROLD PENDLETON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, LPC, LCDC
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
17475
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11451816
CAQH PROVIDER ID
TX
05
—
1508236-01
—
TX
01
—
2119098
CIGNA BEHAVIORAL HEALTH
TX
01
—
551895
VALUE OPTIONS
TX
01
—
6088LC
BLUECROSS/BLUESHIELD
TX
01
—
719494000
MAGELLAN
TX
01
—
7605707
AETNA
TX
01
—
PENDL-0002
COMPCARE PROVIDER ID
TX
Enumeration date
06/15/2005
Last updated
02/02/2012
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