Elizabeth Chase Pennell

Individual provider Active NPI Social Worker · Simpsonville, SC

NPI 1164071502 · NPPES record last updated Sep 9, 2019

Key facts

NPI
1164071502
Entity type
Individual (NPI type 1)
Primary specialty
Social Worker 104100000X
License
6096 (SC)
Practice address
20 Powderhorn Rd
Simpsonville, SC 29681-3399
Phone
(864) 963-3421
NPI assigned
Sep 9, 2019
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
6096SCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
South Carolina Dept of Mental Health Accounting Office Current
since Sep 15, 2019
Accepting new patients
South Carolina Dept of Mental Health Accounting Office Past
since Sep 15, 2019
Accepting new patients

Locations

20 Powderhorn Rd
Simpsonville, SC 29681
Phone (864) 297-5044

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6096 SC Yes

Addresses

Primary practice location

20 Powderhorn Rd
Simpsonville, SC 29681-3399

Mailing address

20 Powderhorn Rd
Simpsonville, SC 29681-3399
Phone (864) 963-3421

Other providers in Simpsonville, SC

All providers in Simpsonville, SC · Social Worker in South Carolina

Sources for this page

Verify at the official NPI Registry.