Active NPI
Katherine Penry
- Clinical Psychologist
- Daphne, AL
National Provider Identifier
1407276033
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1871
- Practice address
- 1203 US Highway 98
Unit 3B
Daphne, AL 36526-4277 - Phone
- (504) 780-1702
- Fax
- (504) 780-1705
- NPI assigned
- Apr 22, 2014
- Last updated
- Apr 22, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1871 | AL | Primary |
Addresses
Primary practice location
1203 US Highway 98
Unit 3B
Daphne, AL 36526-4277
Mailing address
2901 N I 10 Service Rd E
Ste 300
Metairie, LA 70002-6137
Phone (504) 780-1702
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1871 | AL | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Penry Psychology, LLC | Clinical | Current | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Clinical Psychologist
- Fairhope, AL
- NPI 1457231599
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1398124800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1398124800000",
"number": "1407276033",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2901 N I 10 SERVICE RD E",
"address_2": "STE 300",
"city": "METAIRIE",
"state": "LA",
"postal_code": "700026137",
"telephone_number": "504-780-1702",
"fax_number": "504-780-1705"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1203 US HIGHWAY 98",
"address_2": "UNIT 3B",
"city": "DAPHNE",
"state": "AL",
"postal_code": "365264277",
"telephone_number": "504-780-1702",
"fax_number": "504-780-1705"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENRY",
"first_name": "KATHERINE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-04-22",
"last_updated": "2014-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "AL",
"license": "1871",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Daphne, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 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.