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PERNICANO PROFESSIONAL PSYCHOLOGY PLLC NPI 1417518556


NPI Information

NPI: 1417518556
Provider Name: PERNICANO PROFESSIONAL PSYCHOLOGY, PLLC
Classification: Psychologist - 103TC0700X
Entity Type: Organization

Specialization: Clinical

Address:
8800 VILLAGE DRIVE
STE 209
SAN ANTONIO, TX
ZIP 78217
Phone: (210) 202-0100
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PERNICANO PROFESSIONAL PSYCHOLOGY, PLLC is a clinical psychologist in San Antonio, TX. The provider is a psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems. PERNICANO PROFESSIONAL PSYCHOLOGY, PLLC NPI is 1417518556. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

8800 VILLAGE DRIVE
STE 209
SAN ANTONIO, TX
ZIP 78217
Phone: (210) 202-0100
Fax: (210) 579-9705

The provider's authorized official is Kevin Michael Pernicano .
The authorized official title is Owner and has the following contact phone number (210) 278-4584.

The enumeration date for this NPI number is 6/27/2019 and was last updated on 3/16/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103TC0700XPsychologistClinicalYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
13749426MEDICAIDTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.