Individual provider · Type 1 NPI
Kyle Jamison Penniman, MSW, LIAC
Addiction (Substance Use Disorder) Counselor · Phoenix, AZ
NPI number
1922267079
Active
Practice location
4114 E Campbell Ave
Phoenix, AZ 85018-3711
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | None listed |
Addiction (Substance Use Disorder) Counselor: Definition to come...
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About NPI 1922267079
Kyle Jamison Penniman, MSW, LIAC's National Provider Identifier is 1922267079, issued on Jun 4, 2008. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Phoenix, AZ. The record was last updated on Oct 26, 2026.