Provider Demographics
NPI:1437657863
Name:PENNINGTON, DAVID PENNINGTON SCOTT (LSW)
Entity Type:Individual
Prefix:
First Name:DAVID PENNINGTON
Middle Name:SCOTT
Last Name:PENNINGTON
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 MARTINEL DR
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240-4380
Mailing Address - Country:US
Mailing Address - Phone:330-673-6446
Mailing Address - Fax:330-673-6441
Practice Address - Street 1:275 MARTINEL DR
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:OH
Practice Address - Zip Code:44240-4380
Practice Address - Country:US
Practice Address - Phone:330-673-6446
Practice Address - Fax:330-673-6441
Is Sole Proprietor?:No
Enumeration Date:2018-01-31
Last Update Date:2018-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0024351104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker