=====================================================
General NPI Number Information
=====================================================
NPI Number | 1558416941
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | PENNY SUE BROWNING M.A., Q.M.H.P.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/24/2007
-----------------------------------------------------
Last Update Date | 07/16/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 610 CAMPUS DR SUITE 210
-----------------------------------------------------
City | ABINGDON
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 24210-2589
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 276-525-1611
-----------------------------------------------------
Fax | 276-525-1609
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 610 CAMPUS DR SUITE 210
-----------------------------------------------------
City | ABINGDON
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 24210-2589
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 276-525-1611
-----------------------------------------------------
Fax | 276-525-1609
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TC0700X
-----------------------------------------------------
Taxonomy Name | Clinical Psychologist
-----------------------------------------------------
License Number | 942
-----------------------------------------------------
License Number State | WV
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 171M00000X
-----------------------------------------------------
Taxonomy Name | Case Manager/Care Coordinator
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------