Provider Demographics
NPI:1144199621
Name:PENAREDONDO, BLANCHE (LPC-ASSOCIATE)
Entity type:Individual
Prefix:
First Name:BLANCHE
Middle Name:
Last Name:PENAREDONDO
Suffix:
Gender:F
Credentials:LPC-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 AIRPORT FWY STE 2
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76021-5334
Mailing Address - Country:US
Mailing Address - Phone:682-445-0431
Mailing Address - Fax:214-594-9850
Practice Address - Street 1:405 AIRPORT FWY STE 2
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-5334
Practice Address - Country:US
Practice Address - Phone:682-445-0431
Practice Address - Fax:214-594-9850
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-03
Last Update Date:2025-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX96623101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty