Jeanine Ann Penzo, MSW, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

111726 Issued in MA

Practice address

1400 VFW Pkwy
West Roxbury, MA 02132-4927

Phone

(857) 203-6498

Fax

(857) 203-5553

NPI assigned

Sep 20, 2006

Sex

Female

Sole proprietor

No

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194822981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 CHANDLER PL",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024641402",
            "telephone_number": "617-244-1748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 VFW PKWY",
            "city": "WEST ROXBURY",
            "state": "MA",
            "postal_code": "021324927",
            "telephone_number": "857-203-6498",
            "fax_number": "857-203-5553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENZO",
        "first_name": "JEANINE",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "111726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charlotte Pascal, CERTIFICATE
• Karishma Mukul Patel, PHARMD
• Patricia Chiu, DDS, Ms, PC
• Annie Pelissier
• Samantha Pelley, OTR/L
• Adelqui Osvaldo Peralta, MD
• Meghan Colleen Perkins, PA-C
• Patrina Perrington, CNP
• Denise Marie Perron, RNP
• Andrea Perry, LICSW

• Clinical Social Worker in West Roxbury, MA
• Providers in West Roxbury, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.