Penelope A. Smith, M.A.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

PE0000011688 Issued in TN

Practice address

10466 Chestnut Ridge Rd
Lynchburg, TN 37352-5629

Phone

(931) 307-8768

Fax

(931) 759-5176

NPI assigned

Oct 29, 2010

Last updated

Nov 7, 2010By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1288310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289088000000",
    "number": "1245530708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10466 CHESTNUT RIDGE RD",
            "city": "LYNCHBURG",
            "state": "TN",
            "postal_code": "373525629",
            "telephone_number": "931-307-8768",
            "fax_number": "931-759-5176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10466 CHESTNUT RIDGE RD",
            "city": "LYNCHBURG",
            "state": "TN",
            "postal_code": "373525629",
            "telephone_number": "931-307-8768",
            "fax_number": "931-759-5176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "PENELOPE",
        "middle_name": "A.",
        "name_prefix": "Ms.",
        "credential": "M.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-29",
        "last_updated": "2010-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TN",
            "license": "PE0000011688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Price, PT
• Deadra Renea Quinn, APN
• Robert R Yasui (Lynchburg Medical Clinic)
• Robert W Gray (Lynchburg Drug Store)
• Shelbyville Hospital Corporation (Lynchburg Family Medicine and Minor Emergency Center)
• State of Tennessee (Metro Moore Health Facility)
• Jana M. Stovall, NP
• Univita of Tennessee, Inc.
• Cathleen Marie Vaughan, M.S.S.W.
• Robert R Yasui, PA-C

• Mental Health Counselor in Lynchburg, TN
• Providers in Lynchburg, TN by specialty
• Mental Health Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.