Vida Lynne Penn-Leon, LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

10379 Issued in MD

Practice address

917 Hoffmaster Rd # MD
Knoxville, MD 21758-1216

Phone

(888) 458-5199

Fax

(240) 337-8598

NPI assigned

Apr 4, 2007

Last updated

Feb 15, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MD, VA, NM3 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 3

Specialty

Clinical Social Worker

Education

Other

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: vidapennleon@tdh.allscriptsdirect.net

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

• Pivots Potential LLC

  • Clinical Social Worker
  • Hagerstown, MD
  • NPI 1659097525

  VA

  Medicare reassignment NPD
• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Clinical

  NPD
• Vida Lynne Penn Pick, LCSW-C

  • Clinical Social Worker
  • Frederick, MD
  • NPI 1316322712
  NPD (past)

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739577600000",
    "number": "1225150980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1631 WESEL BLVD # 1047",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217405387",
            "telephone_number": "888-458-5199",
            "fax_number": "240-337-8598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "917 HOFFMASTER RD # MD",
            "city": "KNOXVILLE",
            "state": "MD",
            "postal_code": "217581216",
            "telephone_number": "888-458-5199",
            "fax_number": "240-337-8598"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1209 Mountain Road Pl NE # 4433",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871107845",
            "country_code": "US",
            "telephone_number": "888-458-5199",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5900 Balcones Dr # 16280",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787314257",
            "country_code": "US",
            "telephone_number": "888-458-5199",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3900 Westerre Pkwy Ste 300",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232331339",
            "country_code": "US",
            "telephone_number": "888-458-5199",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "33 W Franklin St Ste 2",
            "address_purpose": "LOCATION",
            "city": "Hagerstown",
            "state": "MD",
            "postal_code": "217404826",
            "country_code": "US",
            "telephone_number": "888-458-5199",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1631 Wesel Blvd # 1047",
            "address_purpose": "LOCATION",
            "city": "Hagerstown",
            "state": "MD",
            "postal_code": "217405387",
            "country_code": "US",
            "telephone_number": "888-458-5199",
            "fax_number": "240-337-8598",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENN-LEON",
        "first_name": "VIDA",
        "middle_name": "LYNNE",
        "name_prefix": "Mrs.",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2025-02-15",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "10379",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904015550",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW-C",
            "identifier": "10379",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW-STATE LICENSE NM",
            "identifier": "SWB-2024-0703",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW - TEXAS",
            "identifier": "115112",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED CLINICAL SOCIAL WORKER",
            "identifier": "0904015550",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danielle Lillian Gallupe
• Kierstan Hahn
• Anecia Lenae Johnson, M.S. ED.
• Holly Knill, L.C.P.C
• Anthony C. a. Malik, DPT
• Kelly Anne Price, LCSWC
• Rebekah Shullenbarger
• Jenna Starr
• Cynthia Jean Toleman, RD LDN

• Clinical Social Worker in Knoxville, MD
• Providers in Knoxville, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.