Individual
CASSANDRA ANN HARTLEY PENNINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW-A, LCAS-A. MSW
Contact information
Practice address
PO BOX 807, WAGRAM, NC 28396-0807
(910) 361-5975
Mailing address
PO BOX 807, WAGRAM, NC 28396-0807
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCAS-27531
NC
1041C0700X
Clinical Social Worker
Primary
P017735
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
236
—
NC
01
—
568946544
BCBS
—
01
—
5874
HEALTH PARTNERS
—
Enumeration date
12/09/2021
Last updated
06/24/2024
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