DR GERALD W PENNIE (NPI# 1235667601) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235667601 |
| Entity Type | Organization |
| Organization Name | DR GERALD W PENNIE |
| Other Organization Name | GERALD PENNIE |
| Practice Address |
3805 22nd St Ste 1c Lubbock TX 79410-1142 |
| Mailing Address |
2735 Genoa Ave Apt 2b Lubbock TX 79407-7848 |
| Practice Telephone | 7134176057 |
| Practice Fax Number | 7134176057 |
| Mailing Telephone | 7134176057 |
| Enumeration Date | 2017-05-31 |
| Last Update Date | 2017-08-07 |
| Authorized Official Name | DR. GERALD WAYNE PENNIE (LEAD COUNSELOR) |
| Authorized Official Telephone | 7134176057 |
| Authorized Official Credential | PHD, LPC, NCC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
72286 | TX | Ambulatory Health Care Facilities |
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
72286 | TX | Ambulatory Health Care Facilities |
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
72286 | TX | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Gerald Pennie | Doing Business As Name - Organization |
| Street Address |
3805 22ND ST STE 1C |
| City | LUBBOCK |
| State | TX |
| Zip Code | 79410-1142 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124436035 | Cody William Dickson | Counselor | 3805 22nd St Ste 1c, Lubbock, TX 79410-1142 | 2014-07-24 |
| 1215595244 | Leah Mailman | Counselor | 3805 22nd St Ste 1c, Lubbock, TX 79410-1142 | 2019-06-04 |
| 1497210678 | Jennifer Sue Morse | Counselor | 3805 22nd St Ste 1c, Lubbock, TX 79410-1142 | 2019-02-01 |
| 1124582705 | Chandra Lasley | Marriage & Family Therapist | 3805 22nd St Ste 1c, Lubbock, TX 79410-1142 | 2019-01-28 |
| 1396273975 | Gerald Wayne Pennie | Counselor | 3805 22nd St Ste 1c, Lubbock, TX 79410-1142 | 2017-05-26 |
| 1376089573 | The Practice: Healing Body, Mind, and Soul Pllc | Counselor | 3805 22nd St Ste 1c, Lubbock, TX 79410-1142 | 2017-01-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548878267 | Covenant Medical Center | Clinic/Center | 3615 19th, Lifestyle Centre-east Parking Garage, Lubbock, TX 79410 | 2020-07-20 |
| 1669038626 | Hub City Anesthesia | Nurse Anesthetist, Certified Registered | 3416 22nd Street, Lubbock, TX 79410 | 2019-05-15 |
| 1912447418 | Lubbock Surgery Center, LLC | Clinic/Center | 3416 22nd St, Lubbock, TX 79410 | 2017-03-02 |
| 1871032698 | Lezlee Berry | Pharmacist | 3615 19th Street, Lubbock, TX 79410 | 2017-02-13 |
| 1376914101 | Matthew Cotton | Nurse Practitioner | 2424 Quaker Ave, Lubbock, TX 79410 | 2015-10-20 |
| 1841534864 | Frank Nwabugwu | Pharmacist | 4120 34th Street, Lubbock, TX 79410 | 2012-11-15 |
| 1689954794 | Dharmendra Kumar | Pediatrics | Covenant Children's Hospital, 4000 24th Street, Lubbock, TX 79410 | 2011-08-19 |
| 1518277177 | T.r.m. Rao, M.d., P.a. | Colon & Rectal Surgery | 3809 22nd Street, Suite C, Lubbock, TX 79410 | 2010-10-18 |
| 1700196672 | Hanford Consultations P.a. | Family Medicine | 4000 22nd Place Suite 100, Lubbock, TX 79410 | 2010-10-13 |
| 1336452598 | Amanda Collins | Specialist | 4801 34th Street, Lubbock, TX 79410 | 2010-07-16 |
| Find all providers in zip 79410 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437674314 | Heather Dalton Dennis, M.a., Lpc, Pllc | Clinic/Center | 4210 48th St, Lubbock, TX 79413-3714 | 2017-08-11 |
| 1972837102 | Patty's Homefront, Inc. | Clinic/Center | 4423 110th St Unit 18, Lubbock, TX 79424-7329 | 2009-09-21 |
| 1730635152 | Community Health Center of Lubbock | Clinic/Center | 1610 5th St, Lubbock, TX 79401-2622 | 2016-08-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982202461 | Browsnville Psychological Center, Pllc | Clinic/Center | 302 Lorenaly Dr Ste E, Brownsville, TX 78526-4332 | 2020-10-15 |
| 1891393542 | Inner Essence Therapy, Consulting and Diagnostic Pllc | Clinic/Center | 24414 Creekview Dr, Spring, TX 77389-3711 | 2020-10-14 |
| 1336746973 | Peace, Hope & Harmony, Inc. | Clinic/Center | 661 E Main St Ste 200-174, Midlothian, TX 76065-3340 | 2020-10-06 |
| 1720695331 | Perspectives Psychotherapies, Pllc | Clinic/Center | 8330 Meadow Rd Ste 200, Dallas, TX 75231-0314 | 2020-09-28 |
| 1154935476 | A Work of Heart Therapy, Pllc | Clinic/Center | 10650 Culebra Rd # 104-174, San Antonio, TX 78251-4949 | 2020-09-03 |
| 1144833625 | Mind Above Matter LLC | Clinic/Center | 5900 Hereford Dr, Fort Worth, TX 76179-3395 | 2020-08-25 |
| 1407469067 | Daybreak Wellness, Pllc | Clinic/Center | 1666 N Hampton Rd Ste 103, Desoto, TX 75115-2390 | 2020-08-24 |
| 1487263000 | Stay Young Mental Health & Wellness | Clinic/Center | 8209 Roughrider Dr Ste 210, Windcrest, TX 78239-2457 | 2020-07-29 |
| 1285242305 | Abide Counseling Pllc | Clinic/Center | 505 Church Ave Ste B, College Station, TX 77840-1336 | 2020-07-14 |
| 1275151912 | Inger Daniels Aprn | Clinic/Center | 1937 Texas Pkwy Ste A, Missouri City, TX 77489-3121 | 2020-07-09 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.