Kristel Pennington, LADAC, LCDC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CAD0190821 Issued in NM

Practice address

1220 Addybrook St
Conway, AR 72032-5838

Phone

(501) 428-6978

NPI assigned

Mar 15, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Conway County Community Service Inc.

  • Community/Behavioral Health Agency
  • Morrilton, AR
  • NPI 1770631467
  NPD (past)

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

{
    "created_epoch": "1363305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1689915605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 ADDYBROOK ST",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720325838",
            "telephone_number": "501-428-6978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 ADDYBROOK ST",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720325838",
            "telephone_number": "501-428-6978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNINGTON",
        "first_name": "KRISTEL",
        "credential": "LADAC, LCDC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-15",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NM",
            "license": "CAD0190821",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "13678",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "195277795",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caleigh Peebles
• James Peer
• Savannah Noel Peery
• Morgan Kay Pelley
• Ronald J Pelz, PSYD
• Allyson Penrod, PT
• Kourtney Perdue, APRN
• Jatzary Perez-Avitia
• Amy Perez, LPC
• Shelby M Perez

• Addiction (Substance Use Disorder) Counselor in Conway, AR
• Providers in Conway, AR by specialty
• Addiction (Substance Use Disorder) Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; 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.