Heather Penske, MS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP-1298 Issued in ID

Practice address

1397 North Biztown Loop
Hayden, ID 83835-5044

Phone

(208) 762-3502

NPI assigned

Mar 27, 2013

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Periwinkle Children's Therapy

  • Contractor
  • Hayden, ID
  • NPI 1184972184
  NPD (past)
• Periwinkle Children's Therapy

  • Community/Behavioral Health Agency
  • Coeur d'Alene, ID
  • NPI 1598211856
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1364342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364342400000",
    "number": "1164765251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1397 NORTH BIZTOWN LOOP",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838355043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1397 NORTH BIZTOWN LOOP",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838355044",
            "telephone_number": "208-762-3502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENSKE",
        "first_name": "HEATHER",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-27",
        "last_updated": "2013-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ID",
            "license": "SLP-1298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer G Palmer, FNP
• Panhandle Health District
• Simone Paras, LMT
• Nicole Marie Parquette, PA-C
• Brigette D Pender, LCSW
• Periwinkle Children's Therapy
• Peterson Place Afh Inc (Peterson Place Assisted Living)
• Chax Brandon Peterson, PHARM. D.
• Tracey Peterson, PHARM D
• Lindsey Nichole Petrick, LCSW

• Speech-Language Pathologist in Hayden, ID
• Providers in Hayden, ID by specialty
• Speech-Language Pathologist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.