MEDICARE: JAMES PENNINGTON LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	4360	AL
2	101YP2500X	Professional Counselor	282577	KY

General Provider Information

NPI Number	:	1063098192
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES PENNINGTON LPC

Provider Business Mailing Address
First Line	:	635 W COLLEGE ST
Second Line	:
City	:	FLORENCE
State	:	AL
Zip	:	35630-5313
Country	:	US
Telephone Number	:	256-764-3431
Fax Number	:	256-765-2036

Provider Business Practice Location Address
First Line	:	1475 NASHVILLE RD
Second Line	:
City	:	FRANKLIN
State	:	KY
Zip	:	42134-6961
Country	:	US
Telephone Number	:	270-813-1111
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/19/2021
Last Update Date	:	02/17/2023

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Directions to “ JAMES PENNINGTON LPC” Practice Location

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