JENNIFER PENICK (NPI# 1952844219) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1952844219 |
Entity Type | Individual |
Full Name | JENNIFER PENICK |
Credential | MS |
Practice Address |
460 Briarwood Drive Suite 510 Jackson MS 39206 |
Mailing Address |
460 Briarwood Dr Ste 510 Jackson MS 39206 |
Practice Telephone | 6014540521 |
Practice Fax Number | 6019564817 |
Mailing Telephone | 6019564816 |
Mailing Fax Number | 6019564817 |
Enumeration Date | 2016-11-18 |
Last Update Date | 2016-11-18 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MS | 01670076 | 05 |
Street Address |
460 BRIARWOOD DRIVE SUITE 510 |
City | JACKSON |
State | MS |
Zip Code | 39206 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023661824 | Latoya Lanette Trunell | Occupational Therapy Assistant | 787 East Northside Drive, Jackson, MS 39206 | 2019-07-20 |
1649839291 | Andrew Harris | Dentist | 4505 I-55 Frontage Rd. N, Jackson, MS 39206 | 2019-06-07 |
1679065916 | Savannah Lee Zachry | Physical Therapist | 5140 Galaxie Dr Ste 108, Jackson, MS 39206 | 2018-06-02 |
1669987723 | Harmony House Calls LLC | Nurse Practitioner | 5140 Galaxie Dr Ste 105, Jackson, MS 39206 | 2017-12-11 |
1841719903 | Yolanda Yvette Bell | Nurse Practitioner | 6064 Whitestone Rd, Jackson, MS 39206 | 2017-09-10 |
1760907117 | Anthony Brown Jr. | Physical Therapist | 5411 I-55 North, Jackson, MS 39206 | 2017-08-07 |
1114457132 | Ambric N Williams | Occupational Therapy Assistant | 6017 Whitestone Rd, Jackson, MS 39206 | 2017-06-13 |
1952835613 | Peak Chiropractic Care, LLC | Chiropractor | 4915 I-55 North, Suite 201b, Jackson, MS 39206 | 2017-04-19 |
1447798293 | Peterkin and Associates of Mississippi Inc | Community/Behavioral Health | 5155 Galaxie Drive, Suite F, Jackson, MS 39206 | 2017-02-01 |
1558718304 | Telehealthone, LLC | Nurse Practitioner | 225 Meadowbrook Road, Jackson, MS 39206 | 2016-05-23 |
Find all providers in zip 39206 |
Taxonomy Code | 101YM0800X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
Specialization | Mental Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1629677893 | Jackson Healing Clinic LLC | Counselor | 2020 Cascade Dr, Jackson, MI 49203-3810 | 2020-10-20 |
1568069524 | Philip Ray Nicholas | Counselor | 19 Wood Duck Cv, Jackson, TN 38305-6632 | 2020-10-02 |
1184242711 | New Life Goals, LLC | Counselor | 504 Cooper Rd, Jackson, MS 39212-4704 | 2020-07-09 |
1548881048 | Gloria Dansby-giles | Counselor | 4500 Interstate 55, North; Suite 220, Jackson, MS 39211 | 2020-05-06 |
1962023812 | Kandace Ross | Counselor | 528 Woodbury Rd, Jackson, MS 39206-4830 | 2020-05-01 |
1629600945 | Modern Hope of Ms,llc | Counselor | 5825 Kings Pl, Jackson, MS 39211-3321 | 2020-02-05 |
1003447657 | Chandler & Associates, LLC | Counselor | 1900 Dunbarton Dr Ste G, Jackson, MS 39216-5015 | 2020-02-03 |
1659910701 | Laura E Rutledge | Counselor | 1437 Old Square Rd Ste 101, Jackson, MS 39211-5533 | 2020-01-06 |
1154960961 | Timothy A Norris | Counselor | 5026 Raintree Dr, Jackson, MS 39272-5753 | 2019-12-26 |
1982243838 | Paula Jane Blocker | Counselor | 401 West St Ste 117, Jackson, MN 56143-1219 | 2019-12-24 |
Find all providers in JACKSON |
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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.