Joy Pellerin, LPC

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

71779 Issued in TX

Practice address

25752 Kingsland Blvd
Katy, TX 77494-2086

Phone

(281) 392-7505

Fax

(281) 392-7560

NPI assigned

Jun 15, 2015

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lutheran Social Services of the South, Inc.

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Katy, TX
  • NPI 1801942057

  Residential Treatment Facility, Emotionally Disturbed Children

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1434326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434326400000",
    "number": "1104207265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25752 KINGSLAND BLVD",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774942086",
            "telephone_number": "281-392-7505",
            "fax_number": "281-392-7560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25752 KINGSLAND BLVD",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774942086",
            "telephone_number": "281-392-7505",
            "fax_number": "281-392-7560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLERIN",
        "first_name": "JOY",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-15",
        "last_updated": "2015-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "TX",
            "license": "71779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justin Robert Pedigo
• Pedlar Cosmetic and Family Dentistry PLLC
• Christopher Michael Pedlar, DDS
• Alina Peet
• Wendy Pellegrino
• Olga Alicia Pena Iralda, NP
• Bryan Pena, RBT, CPR
• Georgina Pena
• Lucy J Pena
• Maiya Pena

• Emotionally Disturbed Childrens' Residential Treatment Facility in Katy, TX
• Providers in Katy, TX by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.