Penny Jaymes Clark, L.M.H.C.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

00733 Issued in IA

Practice address

1290 Jordan St
North Liberty, IA 52317-8020

Phone

(319) 356-6352

Fax

(319) 358-2367

NPI assigned

Mar 2, 2010

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

Opted out of Medicare

Previously, effective Aug 1, 2024 through Aug 1, 2026

Medicare enrollment (NPD)

Not enrolled

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.

• Psychiatric Associates of Iowa, PC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • North Liberty, IA
  • NPI 1568121457
  NPD
• Psychiatric Associates of Iowa, PC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • North Liberty, IA
  • NPI 1720709074
  NPD
• Flanagan Obrien Mental Wellness PLLC

  • Mental Health Counselor
  • Coralville, IA
  • NPI 1568147353
  NPD (past)

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

{
    "created_epoch": "1267488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1912220161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1290 JORDAN ST",
            "city": "NORTH LIBERTY",
            "state": "IA",
            "postal_code": "523178020",
            "telephone_number": "319-356-6352",
            "fax_number": "319-358-2367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1290 JORDAN ST",
            "city": "NORTH LIBERTY",
            "state": "IA",
            "postal_code": "523178020",
            "telephone_number": "319-356-6352",
            "fax_number": "319-358-2367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "PENNY",
        "middle_name": "JAYMES",
        "name_prefix": "Ms.",
        "credential": "L.M.H.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-02",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "00733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abigail Marie Christensen, DPT
• Chrysalize, LLC
• Brianna June Clarahan, D.P.T.
• Clarity Point Counseling, LLC
• Clark Orthodontics, Inc.
• Sarah Elizabeth Clark, DDS, MS
• Tanner Jay Clark, D.D.S., M.S.
• Morgen Clay, SLP
• Kristina L Cobb, RN
• Stephany Amanda Cochran, ASCP(CM)

• Mental Health Counselor in North Liberty, IA
• Providers in North Liberty, IA by specialty
• Mental Health Counselor in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.