Gregory Penn, LCSW
Individual provider Active NPI Clinical Social Worker · Miami, FL
NPI 1033934740 · NPPES record last updated Jan 13, 2025
Key facts
- NPI
- 1033934740
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- SW19589 (FL)
- Practice address
- 382 NE 191St St
PMB 484554
Miami, FL 33179-3899 - Phone
- (954) 451-2994
- NPI assigned
- Nov 18, 2024
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SW19589 | FL | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SW19589 | FL | Yes |
Addresses
Primary practice location
382 NE 191St St
PMB 484554
Miami, FL 33179-3899
Mailing address
382 NE 191St St
PMB 484554
Miami, FL 33179-3899
Other providers in Miami, FL
- Heidy Penichet Rodriguez
- Marianne Fernandez Penichet
- Miguel Angel Penichet
- Hector L Peniston Feliciano
- Barbara Penkosky
- Emily Rose Penna
- Hannah Marie Penna
- Joseph Ernest Penna
- Matthew Penna
- Ismelda Pennella Barraza
All providers in Miami, FL · Clinical Social Worker in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 13, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.