Individual provider Active NPI

Daniel Frederick Penrod, PH.D.

  • Clinical Psychologist
  • Mars, PA
National Provider Identifier
1902910862
Registry record updated Aug 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY2776 Issued in FL
Practice address
81104 Lost Valley Dr
Mars, PA 16046-4272
Phone
(727) 667-0746
NPI assigned
Aug 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY2776 FL Primary

Addresses

Primary practice location

81104 Lost Valley Dr
Mars, PA 16046-4272

Mailing address

81104 Lost Valley Dr
Mars, PA 16046-4272
Phone (727) 667-0746

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PY2776FLMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785628800000",
    "number": "1902910862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81104 LOST VALLEY DR",
            "city": "MARS",
            "state": "PA",
            "postal_code": "160464272",
            "telephone_number": "727-667-0746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81104 LOST VALLEY DR",
            "city": "MARS",
            "state": "PA",
            "postal_code": "160464272",
            "telephone_number": "727-667-0746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENROD",
        "first_name": "DANIEL",
        "middle_name": "FREDERICK",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2026-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY2776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mars, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 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.