Provider Demographics
NPI:1013720507
Name:PENNINGTON, SHARI (LCSW)
Entity type:Individual
Prefix:MRS
First Name:SHARI
Middle Name:
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 1:96 ONEIDA AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11720-1126
Mailing Address - Country:US
Mailing Address - Phone:631-335-1492
Mailing Address - Fax:
Practice Address - Street 1:96 ONEIDA AVE
Practice Address - Street 2:
Practice Address - City:SOUTH SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11720-1126
Practice Address - Country:US
Practice Address - Phone:631-335-1492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-29
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY070328-01101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health