Individual
THOMAS PENNINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MBA, LCAC, CADAC
Contact information
Practice address
630 E MAIN ST STE 200, RICHMOND, IN 47374-4358
(765) 935-5390
Mailing address
240 N TILLOTSON AVE, MUNCIE, IN 47304-3988
(765) 288-1928
(765) 741-0335
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
87000619A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
87000619A
IN LICENSE
IN
Enumeration date
07/08/2013
Last updated
07/21/2022
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