Provider Demographics
NPI:1568988228
Name:PENNANT, DOROTHY MARGARET (LPC, NCC, CSAC, CP)
Entity Type:Individual
Prefix:DR
First Name:DOROTHY
Middle Name:MARGARET
Last Name:PENNANT
Suffix:
Gender:F
Credentials:LPC, NCC, CSAC, CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 PARK ST NE
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22180-4666
Mailing Address - Country:US
Mailing Address - Phone:571-866-3717
Mailing Address - Fax:
Practice Address - Street 1:133 PARK ST NE
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-4666
Practice Address - Country:US
Practice Address - Phone:757-814-7182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-15
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
321077101YM0800X
DCPRC14962101YP2500X
VA0710102268101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)