Provider Demographics
NPI:1447087390
Name:PENNINGTON, SKYLER CALLIE (PLPC)
Entity type:Individual
Prefix:
First Name:SKYLER
Middle Name:CALLIE
Last Name:PENNINGTON
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8301 E 49TH TER
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64129-2105
Mailing Address - Country:US
Mailing Address - Phone:816-813-2340
Mailing Address - Fax:
Practice Address - Street 1:1836 TILDEN RD
Practice Address - Street 2:
Practice Address - City:GALENA
Practice Address - State:MO
Practice Address - Zip Code:65656-8515
Practice Address - Country:US
Practice Address - Phone:417-538-4673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-16
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2025039669101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health