Provider Demographics
NPI:1124737374
Name:PRENDERGAST, HAPSATU (MA, LBS)
Entity type:Individual
Prefix:
First Name:HAPSATU
Middle Name:
Last Name:PRENDERGAST
Suffix:
Gender:F
Credentials:MA, LBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:826 BUSTLETON PIKE STE 300
Mailing Address - Street 2:
Mailing Address - City:FEASTERVILLE TREVOSE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-6066
Mailing Address - Country:US
Mailing Address - Phone:267-788-6212
Mailing Address - Fax:
Practice Address - Street 1:826 BUSTLETON PIKE STE 300
Practice Address - Street 2:
Practice Address - City:FEASTERVILLE TREVOSE
Practice Address - State:PA
Practice Address - Zip Code:19053-6066
Practice Address - Country:US
Practice Address - Phone:267-788-6212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-16
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH001571101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health