Pennie Raymond

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

98724 Issued in TX

Practice address

1560 E Southlake Blvd Ste 100
Southlake, TX 76092-6462

Phone

(817) 627-4879

NPI assigned

Nov 22, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Pennie G Raymond Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1700611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787184000000",
    "number": "1962277624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1561",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760991561",
            "telephone_number": "817-627-4879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1560 E SOUTHLAKE BLVD STE 100",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926462",
            "telephone_number": "817-627-4879"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2211 Oregon St Ste N",
            "address_purpose": "LOCATION",
            "city": "Oshkosh",
            "state": "WI",
            "postal_code": "549027001",
            "country_code": "US",
            "telephone_number": "817-627-4879",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAYMOND",
        "first_name": "PENNIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-22",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "98724",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WI",
            "license": "1067-228",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PENNIE",
            "last_name": "RAYMOND",
            "middle_name": "G",
            "credential": "LMFT-IT, LPC - A",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Professional Counselor in Southlake, TX
• Providers in Southlake, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.