1. Home
  2. Directory
  3. Minnesota
  4. White Bear Lake
  5. Counselor
  6. NPI Profile

MS. KATHLEEN JO PENN LPCC
NPI 1215787338
Counselor - Mental Health in White Bear Lake, MN

Active since March 22, 2024PECOS EnrolledAccepts Medicare Assignment
4710 WHITE BEAR PKWY, WHITE BEAR LAKE, MN 55110(651) 443-9290 Get Directions Write a Review

NPPES record last updated: March 22, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Ms. Kathleen Jo Penn Lpcc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. KATHLEEN JO PENN LPCC (NPI 1215787338) is an individual mental health provider in White Bear Lake, Minnesota, licensed in Minnesota (CC04005) and active in the NPI registry since March 2024. She is enrolled in Medicare PECOS and is a graduate of Other (2018).

NPPES Registry Identity

NPI1215787338
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameMS. KATHLEEN JO PENNCredential: LPCC
Location Address4710 WHITE BEAR PKWYWhite Bear Lake, MN 55110-3485
Mailing Address5625 138th St NHugo, MN 55038-8200 · (651) 387-6244
Phone(651) 443-9290
Sole ProprietorYes
Medical School CMSOtherGraduated 2018
Enumeration DateMarch 22, 2024
NPPES CertifiedMarch 22, 2024
✔ NPI 1215787338 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in MN · CC04005
4710 WHITE BEAR PKWY, White Bear Lake, MN 55110
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ms. Kathleen Jo Penn Lpcc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3971078510
PECOS Enrollment IDI20260410002046
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kathleen Penn's NPI number?

The NPI number for Kathleen Penn is 1215787338. It was assigned to this individual provider in the NPPES registry on March 22, 2024.

Where is Kathleen Penn located?

Kathleen Penn practices at 4710 White Bear Pkwy, White Bear Lake, MN 55110. The listed phone number is (651) 443-9290.

What is Kathleen Penn's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Kathleen Penn enrolled in Medicare?

Yes. Kathleen Penn is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Kathleen Penn was last updated on March 22, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.