Provider Demographics
NPI:1538848676
Name:PENNY DROP THERAPY, INC
Entity type:Organization
Organization Name:PENNY DROP THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DRISCOLL
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:630-327-1167
Mailing Address - Street 1:PO BOX 592
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-0592
Mailing Address - Country:US
Mailing Address - Phone:630-327-1167
Mailing Address - Fax:
Practice Address - Street 1:800 ROOSEVELT RD STE A15
Practice Address - Street 2:
Practice Address - City:GLEN ELLYN
Practice Address - State:IL
Practice Address - Zip Code:60137-5800
Practice Address - Country:US
Practice Address - Phone:630-327-1167
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty