Provider Demographics
NPI:1922119775
Name:WINKLE, PENNY D (LISW, LPCC)
Entity Type:Individual
Prefix:MS
First Name:PENNY
Middle Name:D
Last Name:WINKLE
Suffix:
Gender:F
Credentials:LISW, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3620 N HIGH ST
Mailing Address - Street 2:STE. 303
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-3611
Mailing Address - Country:US
Mailing Address - Phone:614-262-5677
Mailing Address - Fax:614-263-0101
Practice Address - Street 1:3620 N HIGH ST
Practice Address - Street 2:STE. 303
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3611
Practice Address - Country:US
Practice Address - Phone:614-262-5677
Practice Address - Fax:614-263-0101
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE 913101YM0800X
OHI 30421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical