Individual
KRISTEL PENNINGTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADAC, LCDC
Contact information
Practice address
1220 ADDYBROOK ST, CONWAY, AR 72032-5838
(501) 428-6978
Mailing address
1220 ADDYBROOK ST, CONWAY, AR 72032-5838
(501) 428-6978
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
13678
TX
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CAD0190821
NM
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
195277795
—
AR
Enumeration date
03/15/2013
Last updated
09/18/2024
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