Provider Demographics
NPI:1609926559
Name:PENNINGTON, SONJA SU (LCSW)
Entity Type:Individual
Prefix:
First Name:SONJA
Middle Name:SU
Last Name:PENNINGTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2116 WATERBURY PL
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76013-5311
Mailing Address - Country:US
Mailing Address - Phone:817-654-3900
Mailing Address - Fax:817-654-3900
Practice Address - Street 1:2116 WATERBURY PL
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76013-5311
Practice Address - Country:US
Practice Address - Phone:817-654-3900
Practice Address - Fax:817-654-3900
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17207101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health