Individual provider Active NPI

Penny Haight, MED., LPC-S

  • Professional Counselor
  • Fort Worth, TX
National Provider Identifier
1225443252
Registry record updated Jun 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
63788 Issued in TX
Practice address
4545 Bellaire Dr S Ste 6
Fort Worth, TX 76109-1811
Phone
(817) 578-1011
NPI assigned
Jun 28, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 63788 TX Primary

Addresses

Primary practice location

4545 Bellaire Dr S Ste 6
Fort Worth, TX 76109-1811

Mailing address

1104 Mallard Way
Granbury, TX 76048-2674
Phone (817) 578-1011

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
63788TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling by Penny Professional Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1403913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403913600000",
    "number": "1225443252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 MALLARD WAY",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760482674",
            "telephone_number": "817-578-1011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 BELLAIRE DR S STE 6",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761091811",
            "telephone_number": "817-578-1011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAIGHT",
        "first_name": "PENNY",
        "name_prefix": "Mrs.",
        "credential": "MED., LPC-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-28",
        "last_updated": "2014-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "63788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2014; 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.