Tracey Lynn Penrod, LPCC-S, LCDC III

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

E0500233 Issued in OH

Practice address

626 30TH St NW
Canton, OH 44709-3112

Phone

(330) 815-7935

NPI assigned

Jun 6, 2023

Sex

Female

Sole proprietor

No

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

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/HDGCDA

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

• Springvale Health Centers,Inc

  • Federally Qualified Health Center (FQHC)
  • Dover, OH
  • NPI 1396577276
  NPD (past)

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

{
    "created_epoch": "1686009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1184318792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "626 30TH ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447093112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "626 30TH ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447093112",
            "telephone_number": "330-815-7935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENROD",
        "first_name": "TRACEY",
        "middle_name": "LYNN",
        "credential": "LPCC-S, LCDC III",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-06",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E0500233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hollie Pena
• Hsiao CHI Peng
• Allison Renee Pennington
• Nicole Penny
• Lorelei Penrod, LPN, CHPLN
• Anthony S Pentz, M.D.
• Kyle Matthew Pentz, DO
• Lawrence Charles Penvose, DO
• People Developed Systems
• People Developed Systems Inc

• Professional Counselor in Canton, OH
• Providers in Canton, OH by specialty
• Professional Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2023; 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.