Individual provider Active NPI

Jaclyn E Penny

  • Counselor
  • Dayton, OH
National Provider Identifier
1932610748
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
601 S Edwin C Moses Blvd
Samaritan Behavioral Health, Inc.
Dayton, OH 45417-3424
Phone
(937) 746-1154
NPI assigned
Oct 19, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Professional Counselor 101YP2500X
Counselor 101Y00000X Primary

Addresses

Primary practice location

601 S Edwin C Moses Blvd
Samaritan Behavioral Health, Inc.
Dayton, OH 45417-3424

Mailing address

601 S Edwin C Moses Blvd, 4TH Floor NW BLDG
Samaritan Behavioral Health Inc
Dayton, OH 45417-3424
Phone (937) 734-8333

Other practice location 1

601 S Edwin C Moses Blvd
Dayton, OH 45417-3424
Phone (937) 734-8333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240123004366 OH Practitioner - Mental Health Counselor 4880046036 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Uvpc Specialists, Inc.Group PAC ID 8921022260, 80 clinicians

Practice addresses (Care Compare)

3130 N Country Rd
25A
Troy, OH 45373-1337
Phone (937) 440-7626

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Uvpc Specialists, Inc. CurrentSince Jun 1, 2025 Accepting new patients
Uvpc Specialists Inc. CurrentSince Jun 1, 2025 Accepting new patients
Samaritan Behavioral Health, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Samaritan Behavioral Health, Inc. Current Accepting new patients
Samaritan Behavioral Health, Inc. CurrentSince Jan 1, 2024 Accepting new patients

Locations

601 S Edwin C Moses Blvd
Fl 4
Dayton, OH 45417
Phone (937) 734-8333

601 S Edwin C Moses Blvd
Dayton, OH 45417
Phone (937) 734-4310

3130 N County Road 25A
Uppr Vly
Troy, OH 45373
Phone (937) 335-3561

3130 N County Road 25A
Ste 212
Troy, OH 45373
Phone (937) 335-0061

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/sbhihelp/r4/

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1508371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1932610748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 S EDWIN C MOSES BLVD, 4TH FLOOR NW BLDG",
            "address_2": "SAMARITAN BEHAVIORAL HEALTH INC",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454173424",
            "telephone_number": "937-734-8333",
            "fax_number": "937-734-4343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 S EDWIN C MOSES BLVD",
            "address_2": "SAMARITAN BEHAVIORAL HEALTH, INC.",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454173424",
            "telephone_number": "937-746-1154"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 S Edwin C Moses Blvd",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454173424",
            "country_code": "US",
            "telephone_number": "937-734-8333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENNY",
        "first_name": "JACLYN",
        "middle_name": "E",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-19",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.