Active NPI
Tina Bates Pennington, L.P.C.
- Addiction (Substance Use Disorder) Counselor
- Nixa, MO
National Provider Identifier
1760547723
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 2000153606
- Practice address
- 308 N Laurel LN
Nixa, MO 65714-8582 - Phone
- (417) 848-7356
- Fax
- (417) 725-7701
- NPI assigned
- Dec 27, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 2000153606 | MO | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 2000153606 | MO | Primary |
| Mental Health Counselor | 101YM0800X | 2000153606 | MO |
Addresses
Primary practice location
308 N Laurel LN
Nixa, MO 65714-8582
Mailing address
PO Box 2356
Nixa, MO 65714-2356
Phone (417) 848-7356
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11564203 | Other | MO | CACQ PROVIDER ID |
| 2000153606 | Other | MO | L.P.C. LICENSE NUMBER |
| 494644305 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2000153606 | MO | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1760547723",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2356",
"city": "NIXA",
"state": "MO",
"postal_code": "657142356",
"telephone_number": "417-848-7356",
"fax_number": "417-725-7701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "308 N LAUREL LN",
"city": "NIXA",
"state": "MO",
"postal_code": "657148582",
"telephone_number": "417-848-7356",
"fax_number": "417-725-7701"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENNINGTON",
"first_name": "TINA",
"middle_name": "BATES",
"credential": "L.P.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-27",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "MO",
"license": "2000153606",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MO",
"license": "2000153606",
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MO",
"license": "2000153606",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CACQ PROVIDER ID",
"identifier": "11564203",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L.P.C. LICENSE NUMBER",
"identifier": "2000153606",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "494644305",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Nixa, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.