Provider Demographics
NPI:1457235525
Name:PENROD, ALYSSA JOY (LMFT)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:JOY
Last Name:PENROD
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:ALYSSA
Other - Middle Name:JOY
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1075 LIGHT BLVD
Mailing Address - Street 2:
Mailing Address - City:FOREST
Mailing Address - State:VA
Mailing Address - Zip Code:24551-5094
Mailing Address - Country:US
Mailing Address - Phone:888-808-6050
Mailing Address - Fax:
Practice Address - Street 1:1075 LIGHT BLVD
Practice Address - Street 2:
Practice Address - City:FOREST
Practice Address - State:VA
Practice Address - Zip Code:24551-5094
Practice Address - Country:US
Practice Address - Phone:888-808-6050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-02
Last Update Date:2025-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0717002476106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist