Individual
MS. LYNDA CANNEZZARO PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSED., LP, LCDC, NBC
Contact information
Practice address
2822 MEADOW BROOK CT, LEAGUE CITY, TX 77573-4344
(954) 644-9521
Mailing address
2822 MEADOW BROOK CT, LEAGUE CITY, TX 77573-4344
(954) 644-9521
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
78008
TX
101YA0400X
Addiction (Substance Use Disorder) Counselor
13912
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13912
TEXAS STATE BOARD OF EXAMINERS OF PROFESSIONAL COUNSELORS
TX
01
—
78008
TEXAS STATE BOARD OF EXAMINERS OF PROFESSIONAL COUNSELORS
TX
01
—
833028
NATIONAL BOARD CERTIFIED COUNSELOR
TX
Enumeration date
03/23/2020
Last updated
03/23/2020
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