Provider Demographics
NPI:1225724438
Name:PENNYBAKER, KARA SIMONE (MPC, MA)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:SIMONE
Last Name:PENNYBAKER
Suffix:
Gender:F
Credentials:MPC, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 RIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:BRADDOCK
Mailing Address - State:PA
Mailing Address - Zip Code:15104-2912
Mailing Address - Country:US
Mailing Address - Phone:412-540-9465
Mailing Address - Fax:
Practice Address - Street 1:1520 RIDGE AVE
Practice Address - Street 2:
Practice Address - City:BRADDOCK
Practice Address - State:PA
Practice Address - Zip Code:15104-2912
Practice Address - Country:US
Practice Address - Phone:412-540-9465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-12
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor