Healthcare Provider Details

I. General information

NPI: 1194543116
Provider Name (Legal Business Name): DAVID PENNINGTON THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2024
Last Update Date: 10/09/2024
Certification Date: 10/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1634 I ST NW STE 1200
WASHINGTON DC
20006-4011
US

IV. Provider business mailing address

1634 I ST NW STE 1200
WASHINGTON DC
20006-4011
US

V. Phone/Fax

Practice location:
  • Phone: 609-364-4007
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DAVID PENNINGTON
Title or Position: OWNER
Credential: LICSW
Phone: 202-851-2670