Individual
JAMES RUSSELL PENDERGAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LPC-A, NCC
Contact information
Practice address
1901 VETERANS MEMORIAL DR, TEMPLE, TX 76504-7445
(785) 341-5447
Mailing address
1709 NEUBERRY CLIFFE, TEMPLE, TX 76502-5691
(785) 341-5447
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
89082
TX
Other
Enumeration date
04/13/2023
Last updated
04/13/2023
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