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Individual
JOHNERIC PENNEY
Active
Individual
JOHNERIC PENNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SUDPT
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CG60896399
WA
171M00000X
Case Manager/Care Coordinator
—
—
175T00000X
Peer Specialist
—
—
251B00000X
Case Management Agency
BHA.FS.61643379
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1164175725
—
WA
Enumeration date
02/02/2022
Last updated
11/20/2025
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