MEDICARE: KIM PENFOUND

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	E.2102524-SUPV
2	1041S0200X	School Social Worker	OH3053722	OH
3	101YP2500X	Professional Counselor	E.2102524	OH

General Provider Information

NPI Number	:	1952761629
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIM PENFOUND

Provider Business Mailing Address
First Line	:	5995 WILCOX PL STE D
Second Line	:
City	:	DUBLIN
State	:	OH
Zip	:	43016-9267
Country	:	US
Telephone Number	:	614-205-3306
Fax Number	:

Provider Business Practice Location Address
First Line	:	5995 WILCOX PL STE D
Second Line	:
City	:	DUBLIN
State	:	OH
Zip	:	43016-9267
Country	:	US
Telephone Number	:	614-205-3306
Fax Number	:

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

Provider Enumeration Date	:	02/24/2016
Last Update Date	:	03/11/2026

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Directions to “ KIM PENFOUND ” Practice Location

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