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Individual
AMY E PENDERGRASS
Active
Individual
AMY E PENDERGRASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
C2002216TRNE
OH
101YM0800X
Mental Health Counselor
Primary
C.2103215
OH
101YM0800X
Mental Health Counselor
Primary
E.2606161
OH
Other
Enumeration date
01/28/2020
Last updated
01/14/2026
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