Provider Demographics
NPI:1609022409
Name:PENNINGTON, NANCY CARTER (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:CARTER
Last Name:PENNINGTON
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1444 DUKE ST
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-3403
Mailing Address - Country:US
Mailing Address - Phone:202-429-0418
Mailing Address - Fax:703-836-6470
Practice Address - Street 1:1444 DUKE ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-3403
Practice Address - Country:US
Practice Address - Phone:703-836-7130
Practice Address - Fax:703-836-6470
Is Sole Proprietor?:No
Enumeration Date:2008-08-12
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040013931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA28764Medicare PIN