Stacey Michelle Penn, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

107927 Issued in NY

Practice address

300 E 34TH St Apt 6a
New York, NY 10016-4905

Phone

(631) 874-0185

NPI assigned

Mar 31, 2021

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1617148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1043898083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98120 QUEENS BLVD STE 1C",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113744414",
            "telephone_number": "516-220-4530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 E 34TH ST APT 6A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100164905",
            "telephone_number": "631-874-0185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENN",
        "first_name": "STACEY",
        "middle_name": "MICHELLE",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-31",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "107927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Penn, MD
• Lauren Ashley Penn, M.D.
• Madeline Penn, MD
• Mark Eric Penn Jr.
• Michael R Penn, LCSW
• Christina M Penna
• Sara Penna, REGISTERED DIETITIAN
• Stephanie Pennacchia, LCSW
• Shani Pennant, MD
• Michelle Pennasilico

• Social Worker in New York, NY
• Providers in New York, NY by specialty
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.