Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jeffry R Penwarden, PHD, LP

Individual provider Clinical Psychologist · NPI 1871544478

Jeffry R Penwarden, PHD, LP is a Clinical Psychologist in Forest Lake, Minnesota. Licensed in Minnesota. Registered with an NPI since 2006.

Licensed in
MN
In the registry since
2006
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

1540 Lake St S
Forest Lake, MN 55025-2628
Phone: (651) 464-7100
Fax: (651) 982-5515
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence LP2545 (MN)

Record details

NPI number1871544478
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD , LP
Sole proprietorNo
NPI enumeratedMay 16, 2006
Last updated in NPPESJuly 13, 2026

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