MEDICARE: MRS. JENNIFER DAWN PENNY LPC, LMHC, RPT, NCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1467105114
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JENNIFER DAWN PENNY LPC, LMHC, RPT, NCC

Provider Business Mailing Address
First Line	:	1441 W BAY DR NW STE 101
Second Line	:
City	:	OLYMPIA
State	:	WA
Zip	:	98502-4306
Country	:	US
Telephone Number	:	360-948-5205
Fax Number	:

Provider Business Practice Location Address
First Line	:	1441 W BAY DR NW STE 101
Second Line	:
City	:	OLYMPIA
State	:	WA
Zip	:	98502-4306
Country	:	US
Telephone Number	:	360-948-5205
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/02/2022
Last Update Date	:	10/01/2025

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