Active NPI
Jeanna Pennington, LPC
- Mental Health Counselor
- Fordyce, AR
National Provider Identifier
1427440254
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- P1809130
- Practice address
- 300 N Clifton St
Fordyce, AR 71742-3055 - Phone
- (870) 352-5122
- Fax
- (870) 352-5127
- NPI assigned
- Mar 3, 2015
- Last updated
- May 20, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | A1603037 | AR | |
| Mental Health Counselor | 101YM0800X | P1809130 | AR | Primary |
Addresses
Primary practice location
300 N Clifton St
Fordyce, AR 71742-3055
Mailing address
3611 Farm to Market Rd
New Edinburg, AR 71660
Phone (870) 313-1366
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A1603037 | AR | MD | Mental Health Counselor |
| P1809130 | AR | MD | Mental Health Counselor |
Interoperability endpoints
- jeanna.pennington.1@21565.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1425340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1589932800000",
"number": "1427440254",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3611 FARM TO MARKET RD",
"city": "NEW EDINBURG",
"state": "AR",
"postal_code": "71660",
"telephone_number": "870-313-1366"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 N CLIFTON ST",
"city": "FORDYCE",
"state": "AR",
"postal_code": "717423055",
"telephone_number": "870-352-5122",
"fax_number": "870-352-5127"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENNINGTON",
"first_name": "JEANNA",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-03-03",
"last_updated": "2020-05-20",
"certification_date": "2020-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "AR",
"license": "A1603037",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "AR",
"license": "P1809130",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fordyce, AR
- Alisa Kijuana Oneal, MHPP
- Kimra Lynn Osburn, MHPP
- Sondra Lynn Parker, RN
- Patrick P Moseley Family Dentistry
- Tracy Ann Pefferkorn, LPC
- Debra Perry, MHPP
- Emily Phillips, QBHP
- Pine Forest Health and Rehab Center, LLC (dba Dallas County Nursing Home)
- Pioneer Health Services, Inc. (PHS of Dallas)
- Prescription Store of Fordyce Inc (The Prescription Store)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.