Individual provider · Type 1 NPI

Jeffry R. Penwarden, PhD, LP

Clinical Psychologist · Forest Lake, MN

NPI number 1871544478 Active

Practice location

1540 Lake St S
Forest Lake, MN 55025-2628

Call (651) 464-7100 Map

Fax (651) 982-5515

Mailing address

2925 Chicago Ave
Minneapolis, MN 55407-1321

Specialties and licenses

Taxonomy	Code	License
Clinical Psychologist Primary	103TC0700X	LP2545 (MN)

Clinical Psychologist: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of discip…

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About NPI 1871544478

Jeffry R. Penwarden, PhD, LP's National Provider Identifier is 1871544478, issued on May 16, 2006. The primary taxonomy on file is Clinical Psychologist (103TC0700X), and the practice location is in Forest Lake, MN. The record was last updated on Jul 13, 2026.