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Individual

ISAAC JORDAN PENNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MA, LPCC

Contact information

Practice address
7850 JEFFERSON ST NE STE 300, ALBUQUERQUE, NM 87109-4314
(505) 379-4035
Mailing address
7850 JEFFERSON ST NE STE 300, ALBUQUERQUE, NM 87109-4314
(505) 884-1114
(505) 884-3004

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CTB-2023-0303
NM
101YP2500X
Professional Counselor
Primary
CTB-2026-0086
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
52957306
NM
Enumeration date
10/23/2023
Last updated
02/05/2026
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