Active NPI
Sue Ellen Penley, LCSW
- Clinical Social Worker
- Moulton, AL
National Provider Identifier
1699843441
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 2068C
- Practice address
- 317 Hospital St
Moulton, AL 35650-1269 - Phone
- (256) 355-6105
- NPI assigned
- Dec 1, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 2068C | AL | Primary |
Addresses
Primary practice location
317 Hospital St
Moulton, AL 35650-1269
Mailing address
1316 Somerville Rd SE
Suite 1
Decatur, AL 35601-4305
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2068C | AL | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mental Health Center of North Central Alabama | Past | Accepting new patients | |
| Mental Health Center of North Central Alabama Inc. | Past | Accepting new patients |
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.
-
- Community/Behavioral Health Agency
- Decatur, AL
- NPI 1780859314
-
- Community/Behavioral Health Agency
- Decatur, AL
- NPI 1124193636
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1187654400000",
"number": "1699843441",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1316 SOMERVILLE RD SE",
"address_2": "SUITE 1",
"city": "DECATUR",
"state": "AL",
"postal_code": "356014305"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "317 HOSPITAL ST",
"city": "MOULTON",
"state": "AL",
"postal_code": "356501269",
"telephone_number": "256-355-6105"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENLEY",
"first_name": "SUE",
"middle_name": "ELLEN",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-01",
"last_updated": "2007-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "AL",
"license": "2068C",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moulton, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.