Penzien, Donald

Penzien, Donald is an individual health care provider with primary practice located at 2500 N State St , Jackson MS 39216-4500. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Psychologist is his primary health care specialty. Penzien, Donald can be contacted via phone (601) 984-5808.

Contact Information

Primary practice address
2500 N State St Jackson MS 39216-4500
Phone: (601) 984-5808
Fax: (601) 815-4710
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 28-387 Mississippi
Behavioral Health & Social Service Providers / Psychologist 103T00000X 5203 North Carolina

Profile Details

NPI number 1184661084
LBN Legal business name Penzien, Donald
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date May 31st, 2006
Last updated Nov 27th, 2017 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184661084 NPPES
Mississippi MEDICAID 00114323
Mississippi Other 680010494

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