MEDICARE: ERIN SMITH PENNINGTON

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	101YM0800X	Mental Health Counselor	0701013462	VA

General Provider Information

NPI Number	:	1144073701
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN SMITH PENNINGTON

Provider Business Mailing Address
First Line	:	PO BOX 2322
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22301-0322
Country	:	US
Telephone Number	:	703-828-7878
Fax Number	:

Provider Business Practice Location Address
First Line	:	1011 E MAIN ST STE 310
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23219-3537
Country	:	US
Telephone Number	:	703-828-7878
Fax Number	:

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

Provider Enumeration Date	:	04/11/2024
Last Update Date	:	12/16/2025

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