MEDICARE: RYAN PESCAIA MS, LPC-A

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	101YM0800X	Mental Health Counselor
2	101Y00000X	Counselor
3	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1124801634
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RYAN PESCAIA MS, LPC-A

Provider Business Mailing Address
First Line	:	4119 MONTROSE BLVD STE 460
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77006-4966
Country	:	US
Telephone Number	:	713-807-7518
Fax Number	:

Provider Business Practice Location Address
First Line	:	4119 MONTROSE BLVD STE 460
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77006-4966
Country	:	US
Telephone Number	:	713-510-3507
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2023
Last Update Date	:	12/29/2025

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