Provider Demographics
NPI:1104896778
Name:ONDROVIK, JOANN CATHERINE (PHD, MSCP, LSOTP)
Entity type:Individual
Prefix:DR
First Name:JOANN
Middle Name:CATHERINE
Last Name:ONDROVIK
Suffix:
Gender:F
Credentials:PHD, MSCP, LSOTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3430 FARM ROAD 195
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75462-3058
Mailing Address - Country:US
Mailing Address - Phone:903-785-0746
Mailing Address - Fax:903-785-2982
Practice Address - Street 1:3430 FARM ROAD 195
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75462-3058
Practice Address - Country:US
Practice Address - Phone:903-785-0746
Practice Address - Fax:903-785-2982
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1194-0991103TA0400X
TXAD003151103TA0400X
TX21086103TA0700X, 103TC0700X, 103TC1900X, 103TC2200X, 103TF0200X
OK649103TA0700X, 103TC0700X, 103TC1900X, 103TF0200X
TX964097103TB0200X
TX12505103TH0100X
TX94161103TR0400X
TX5908103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)
Not Answered103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
Not Answered103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Not Answered103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Not Answered103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
Not Answered103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
Not Answered103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation
Not Answered103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00AN79OtherBC/BS PROVIDER ID
TX972530OtherFIRST HEALTH
TX00AN79Medicare ID - Type UnspecifiedMEDICARE PROVIDER ID