Susan Virginia Pennington, MA, MFTI

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

1407 N 13TH St
Boise, ID 83702-3531

Phone

(208) 400-3352

NPI assigned

Sep 25, 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 Arts

Practice roles

Locations

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.

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  NPD (past)

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

{
    "created_epoch": "1380067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565568000000",
    "number": "1194151936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1407 N 13TH ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837023531",
            "telephone_number": "208-400-3352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1407 N 13TH ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837023531",
            "telephone_number": "208-400-3352"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "957 Industrial Rd Ste B",
            "address_purpose": "LOCATION",
            "city": "San Carlos",
            "state": "CA",
            "postal_code": "940704152",
            "country_code": "US",
            "telephone_number": "650-832-6902",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3050 N Lakeharbor Ln Ste 205",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837036243",
            "country_code": "US",
            "telephone_number": "208-400-3352",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENNINGTON",
        "first_name": "SUSAN",
        "middle_name": "VIRGINIA",
        "credential": "MA, MFTI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-25",
        "last_updated": "2019-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Danielle Pense-Nicholson, FNP
• Ian Penwell, CPM

• Counselor in Boise, ID
• Providers in Boise, ID by specialty
• Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2019; 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.