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General NPI Number Information
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NPI Number | 1134435019
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Entity Type | Individual
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Provider Name | PENNY COLLINS LPC, NCC
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Gender | Female
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Dates
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Enumeration Date | 08/30/2010
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Last Update Date | 09/29/2015
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Provider Practice Location Address
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Address Line | 332 CIRCLE P DR
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City | PRESCOTT
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State | AZ
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Zip | 86303-5525
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Country | US
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Telephone | 715-486-6007
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Fax |
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Provider Business Mailing Address
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Address Line | 332 CIRCLE P DR
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City | PRESCOTT
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State | AZ
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Zip | 86303-5525
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Country | US
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Telephone | 715-486-6007
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 3452-125
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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License Number | 311116
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LPC-15394
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License Number State | AZ
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