Individual provider Active NPI

Penney Ann Rockhill, LCPC

  • Mental Health Counselor
  • Idaho Falls, ID
National Provider Identifier
1194082826
Registry record updated Nov 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
4549 Issued in ID
Practice address
1820 E 17TH St Ste 190
Idaho Falls, ID 83404-6518
Phone
(208) 419-6102
Fax
(208) 542-8004
NPI assigned
Apr 19, 2012
Last updated
Nov 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 4549 ID Primary

Addresses

Primary practice location

1820 E 17TH St Ste 190
Idaho Falls, ID 83404-6518

Mailing address

1820 E 17TH St Ste 190
Idaho Falls, ID 83404-6518
Phone (208) 419-6102

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240311003651 ID Practitioner - Mental Health Counselor 9739525874 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1820 E 17TH St
Suite 190
Idaho Falls, ID 83404-6518
Phone (208) 419-6102

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4549IDMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
A Penney for Your Thoughts Mental Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

1820 E 17th St
Ste 190
Idaho Falls, ID 83404
Phone (208) 419-6102

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1334793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1194082826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1820 E 17TH ST STE 190",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046518",
            "telephone_number": "208-419-6102",
            "fax_number": "208-542-8004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 E 17TH ST STE 190",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046518",
            "telephone_number": "208-419-6102",
            "fax_number": "208-542-8004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROCKHILL",
        "first_name": "PENNEY",
        "middle_name": "ANN",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-19",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "4549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.