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General NPI Number Information
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NPI Number | 1851315477
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Entity Type | Individual
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Provider Name | PENNY LYNNE DOLLENS-SMITH MA, LMFT, LMHC, LSW
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Gender | Female
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Dates
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Enumeration Date | 07/27/2006
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Last Update Date | 09/19/2008
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Provider Practice Location Address
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Address Line | 13295 ILLINOIS ST SUITE 324
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City | CARMEL
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State | IN
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Zip | 46032-3019
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Country | US
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Telephone | 317-663-0654
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Fax | 866-481-0076
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Provider Business Mailing Address
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Address Line | 13295 ILLINOIS ST SUITE 324
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City | CARMEL
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State | IN
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Zip | 46032-3019
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Country | US
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Telephone | 317-663-0654
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Fax | 866-481-0076
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 39001121A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 35000789A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 33001683A
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License Number State | IN
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