Madlen Penn, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

183144 Issued in AK

Practice address

2963 W Discovery Loop
Wasilla, AK 99654-1257

Phone

(907) 444-5005

NPI assigned

Oct 13, 2020

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Unlocked Potential, LLC

  • Speech-Language Pathologist
  • Palmer, AK
  • NPI 1730821240
  NPD Authorized official
• Turning Leaf Literacy Center, LLC

  • Clinic/Center
  • Wasilla, AK
  • NPI 1942807862
  NPD (past)

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

{
    "created_epoch": "1602547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631491200000",
    "number": "1659979698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2963 W DISCOVERY LOOP",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996541257",
            "telephone_number": "907-444-5005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2963 W DISCOVERY LOOP",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996541257",
            "telephone_number": "907-444-5005"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "248 S Alaska St",
            "address_purpose": "LOCATION",
            "city": "Palmer",
            "state": "AK",
            "postal_code": "996456334",
            "country_code": "US",
            "telephone_number": "907-444-5005",
            "fax_number": "907-206-7027",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENN",
        "first_name": "MADLEN",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-13",
        "last_updated": "2021-09-13",
        "certification_date": "2021-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AK",
            "license": "183144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://unlockedpotentialak.clientsecure.me/",
            "affiliation": "N",
            "address_1": "2963 W Discovery Loop",
            "city": "Wasilla",
            "state": "AK",
            "country_code": "US",
            "postal_code": "996541257",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Elias V Pedroza V
• Megan Rose Pekkala
• Danielle Peltier
• Danielle Pendergrass
• Justin Pendergrass
• Sandra Lee Pereira
• Lydia Perenyi
• Vincent Frank Perez Jr.
• Vincent Perino
• Cameron Perry

• Speech-Language Pathologist in Wasilla, AK
• Providers in Wasilla, AK by specialty
• Speech-Language Pathologist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2021; 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.