MR. KYLE JAMISON PENNIMAN MSW, LISAC, CADAC
NPI 1922267079
Counselor - Addiction (Substance Use Disorder) in Phoenix, AZ

Q: What is Kyle Penniman's NPI number?

The NPI number for Kyle Penniman is 1922267079. It was assigned to this individual provider in the NPPES registry on June 4, 2008. The provider is also known as Courtney Penniman Msw, Lisac, Cadac.

Q: What is Kyle Penniman's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

Q: When was this NPI record last updated?

The NPPES record for Kyle Penniman was last updated on July 27, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.

Active since June 04, 2008

4020 N 20TH ST STE 302, PHOENIX, AZ 85016(602) 535-6468 Get Directions Write a Review

NPPES record last updated: July 27, 2012. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Mr. Kyle Jamison Penniman Msw, Lisac, Cadac NPPES

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

MR. KYLE JAMISON PENNIMAN MSW, LISAC, CADAC (NPI 1922267079) is an individual addiction (substance use disorder) provider in Phoenix, Arizona and active in the NPI registry since June 2008.

NPPES Registry Identity

NPI1922267079

Entity TypeIndividualMale

Primary Taxonomy101YA0400X

Provider Legal NameMR. KYLE JAMISON PENNIMANCredential: MSW, LISAC, CADAC

Location Address4020 N 20TH ST STE 302Phoenix, AZ 85016-6032

Mailing Address4020 N 20th St Ste 302Phoenix, AZ 85016-6032 · (602) 535-6468

Phone(602) 535-6468

Sole ProprietorYes

Enumeration DateJune 4, 2008

Last NPPES UpdateJuly 27, 2012

✔ NPI 1922267079 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers

Taxonomy Code101YA0400X

4020 N 20TH ST STE 302, Phoenix, AZ 85016

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Other Names 1

Former Name (1)Courtney Penniman Msw, Lisac, Cadac

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MICHAEL S SHAFER MC

Counselor

4020 N 20TH ST STE 302
PHOENIX, AZ 85016

Maricopa County (602) 535-6468

STONEWALL INSTITUTE, LLC

Community/Behavioral Health

4020 N 20TH ST STE 302
PHOENIX, AZ 85016

Maricopa County (602) 535-6468

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 Kyle Penniman's NPI number?

The NPI number for Kyle Penniman is 1922267079. It was assigned to this individual provider in the NPPES registry on June 4, 2008. The provider is also known as Courtney Penniman Msw, Lisac, Cadac.

Where is Kyle Penniman located?

Kyle Penniman practices at 4020 N 20th St Ste 302, Phoenix, AZ 85016. The listed phone number is (602) 535-6468.

What is Kyle Penniman's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Kyle Penniman was last updated on July 27, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.