Andrea Penner, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

P1412133 Issued in AR

Practice address

3102 SE J St
Bentonville, AR 72712-3796

Phone

(479) 236-1052

NPI assigned

Dec 31, 2014

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

State licenses

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

{
    "created_epoch": "1419984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682035200000",
    "number": "1457749251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1152 GIULIA AVE",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727623199",
            "telephone_number": "479-236-1052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3102 SE J ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727123796",
            "telephone_number": "479-236-1052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNER",
        "first_name": "ANDREA",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-31",
        "last_updated": "2023-04-21",
        "certification_date": "2023-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "P1412133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Solomon Michael Pearce, D.O.
• Jaci Pease
• Melissa Lou Peck, LPC MS
• Sarah Peek, LAC
• Rosemary Pelphrey, D.D.S.
• Michael Dean Pennington, M.S.P.T.
• Chelseyray Perez
• Katelyn Perez, PT, DPT
• Nancy Perkins
• Sara Perkins

• Mental Health Counselor in Bentonville, AR
• Providers in Bentonville, AR by specialty
• Mental Health Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2023; 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.