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Individual

ANDREW R PENN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LMHC

Contact information

Practice address
6698 68TH AVE N STE 414, PINELLAS PARK, FL 33781-5015
(727) 405-2450
(727) 405-2450
Mailing address
6524 50TH AVE N, ST PETERSBURG, FL 33709-3112
(727) 405-2450

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
068.0136273TELE
VT
101YM0800X
Mental Health Counselor
Primary
MH17862
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
106080400
FL
01
MH17862
STATE LICENSE
FL
Enumeration date
04/01/2020
Last updated
03/27/2026
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