Trenton Penner, LPC, MCP
Individual provider Active NPI Mental Health Counselor · Dacoma, OK
NPI 1659805604 · NPPES record last updated Nov 22, 2024
Key facts
- NPI
- 1659805604
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 11970 (OK)
- Practice address
- 1052 11TH St
Dacoma, OK 73731-9529 - Phone
- (580) 748-0946
- NPI assigned
- Apr 17, 2017
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 9
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Great Salt Plains Health Center Inc
Practice addresses (Care Compare)
231 S 30TH St
Enid, OK 73701-6455
Phone (580) 596-2800
310 E Walnut St
Canton, OK 73724-9738
Phone (580) 596-2800
405 S Oklahoma Ave
Cherokee, OK 73728-2545
Phone (580) 596-2800
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250310002723 | OK | Practitioner - Mental Health Counselor | 2163943887 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Great Salt Plains Health Center, Inc. | Current |
Accepting new patients | |
| Great Salt Plains Health Center, Inc. | Current |
Accepting new patients | |
| State of Oklahoma | Past | Accepting new patients |
Locations
310 E Walnut
Canton, OK 73724
Phone (580) 886-2200
405 S Oklahoma Ave
Cherokee, OK 73728
Phone 87724284756012
231 S 30th St
Enid, OK 73701
Phone (580) 233-2900
205 W Maple Ave
Ste 1000
Enid, OK 73701
Phone (580) 233-2900
5320 W Chestnut Ave
Enid, OK 73703
Phone (580) 233-2900
115 W Broadway Ave
Enid, OK 73701
619 N Front St
Medford, OK 73759
Phone (580) 395-3200
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | |||
| Mental Health Counselor | 101YM0800X | 11970 | OK | Yes |
| Mental Health Counselor | 101YM0800X |
Addresses
Primary practice location
1052 11TH St
Dacoma, OK 73731-9529
Mailing address
1052 11TH St
Dacoma, OK 73731-9529
Phone (580) 748-0946
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 22, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.