Individual provider Active NPI

Penny W. Galloway

  • Mental Health Counselor
  • Palm Bay, FL
National Provider Identifier
1639015894
Registry record updated Apr 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
IMH28855 Issued in FL
Practice address
2195 San Filippo Dr SE
Palm Bay, FL 32909-7206
Phone
(321) 616-0809
Fax
(321) 616-0809
NPI assigned
Apr 28, 2026
Last updated
Apr 28, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X IMH28855 FL Primary

Addresses

Primary practice location

2195 San Filippo Dr SE
Palm Bay, FL 32909-7206

Mailing address

2195 San Filippo Dr SE
Palm Bay, FL 32909-7206
Phone (321) 616-0809

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

LicenseStateTypeSpecialty
IMH28855FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1777334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777334400000",
    "number": "1639015894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2195 SAN FILIPPO DR SE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329097206",
            "telephone_number": "321-616-0809",
            "fax_number": "321-616-0809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2195 SAN FILIPPO DR SE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329097206",
            "telephone_number": "321-616-0809",
            "fax_number": "321-616-0809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLOWAY",
        "first_name": "PENNY",
        "middle_name": "W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-28",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH28855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Bay, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2026; 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.