Jody Pendleton PSYD, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2859 Issued in CO

Legal business name

JODY PENDLETON PSYD, LLC

Practice address

2480 High St
Canon City, CO 81212-8746

Phone

(719) 251-0773

NPI assigned

Feb 4, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Jody L Pendleton, PSYD, LPC

Title

Licensed Professional Counselor

Phone

(719) 251-0773

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1423008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423008000000",
    "number": "1649660184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2480 HIGH ST",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812128746",
            "telephone_number": "719-251-0773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2480 HIGH ST",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812128746",
            "telephone_number": "719-251-0773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JODY PENDLETON PSYD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-04",
        "last_updated": "2015-02-04",
        "status": "A",
        "authorized_official_last_name": "PENDLETON",
        "authorized_official_first_name": "JODY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "LICENSED PROFESSIONAL COUNSELOR",
        "authorized_official_telephone_number": "719-251-0773",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD, LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "2859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Canon City, CO
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• Professional Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 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.