MRS. KELSEY JO PENIX (NPI# 1407376536) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407376536 |
| Entity Type | Individual |
| Full Name | MRS. KELSEY JO PENIX |
| Credential | LPC - MI, LMHC - NM |
| Practice Address |
9445 Patricia Dr Otisville MI 48463-9406 |
| Practice Telephone | 8102108857 |
| Mailing Telephone | 8102108857 |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2019-05-10 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
6401017288 | MI | Behavioral Health & Social Service Providers |
| N | 101YM0800X |
Counselor Specialization: Mental Health |
CMH0198831 | NM | Behavioral Health & Social Service Providers |
| N | 101YS0200X |
Counselor Specialization: School |
PV0000000820594 | MI | Behavioral Health & Social Service Providers |
| Street Address |
9445 PATRICIA DR |
| City | OTISVILLE |
| State | MI |
| Zip Code | 48463-9406 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568554681 | Great Lakes Family Dental Group - Otisville, P.C. | Dentist | 380 N State, Otisville, MI 48463 | 2006-09-28 |
| 1285696682 | George Mohamedally Do PC | Family Medicine | 387 North State, Otisville, MI 48463 | 2006-04-03 |
| 1760972806 | Jimmy Dale Colley Jr. | Occupational Therapist | 9179 Frances Rd, Otisville, MI 48463-9411 | 2018-05-15 |
| 1285124537 | Dennys Pharmacy LLC | Pharmacy | 410 N State Rd, Otisville, MI 48463-9443 | 2018-05-12 |
| 1114313459 | Shelly Denise Hatchew | Physical Therapy Assistant | 9099 Dodge Rd, Otisville, MI 48463-9449 | 2015-04-14 |
| 1780859363 | Thomas W Wood | Pharmacist | 337 N State Rd, Otisville, MI 48463-9486 | 2008-04-24 |
| 1669503991 | Mary Joy Dela Rosa | Physical Therapist | 391 N State Rd, Suite A, Otisville, MI 48463-9486 | 2007-03-08 |
| 1760574974 | William E Norton II | Dentist | 380 N State Rd, Otisville, MI 48463-9486 | 2006-09-28 |
| 1932218492 | Rite Aid of Michigan Inc | Durable Medical Equipment & Medical Supplies | 337 North State Road, Otisville, MI 48463-9486 | 2006-08-29 |
| 1518579853 | Tijo Thomas Manthuruthil | Pharmacist | 337 N State Rd, Otisville, MI 48463-9486 | 2020-08-18 |
| Find all providers in zip 48463 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316548100 | Grey Street Counseling and Wellness Center, LLC | Counselor | 314 Moonlite Court, Clarkston, MI 48348 | 2020-11-06 |
| 1619578549 | Joy Love Telehealth | Counselor | 444 Beach Farm Cir, Highland, MI 48356 | 2020-11-06 |
| 1407457799 | Next Level Counseling and Consulting, LLC | Counselor | 5231 Grayton St, Detroit, MI 48224-2149 | 2020-11-04 |
| 1760082309 | Lauren Alyssa Rainey | Counselor | 46522 Aarons Way, Canton, MI 48188-2323 | 2020-10-30 |
| 1033719679 | Jonelle Reynoso | Counselor | 140 Lyndenglen Dr Apt 208, Ann Arbor, MI 48103-6979 | 2020-10-30 |
| 1659971802 | Lauren Antoinette Long | Counselor | 732 E Grand Blanc Rd, Grand Blanc, MI 48439-1333 | 2020-10-27 |
| 1811596570 | Cynthia Fulkerth | Counselor | 124 W Gates St Ste 203, Bruce Twp, MI 48065-4493 | 2020-10-22 |
| 1730788530 | Ryan Michael De Nike | Counselor | 4710 W Saginaw Hwy Ste 8, Lansing, MI 48917-2654 | 2020-10-22 |
| 1467051201 | Jennifer Joelle Jacobs | Counselor | 3760 Whispering Way Se Apt 204, Grand Rapids, MI 49546-7601 | 2020-10-22 |
| 1669071585 | Carraus Harden | Counselor | 13238 N Norfolk, Detroit, MI 48235-1026 | 2020-10-21 |
| 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.