Stephanie Pennacchia, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

092232-01 Issued in NY

Practice address

1789 Madison Ave
New York, NY 10035-4537

Phone

(646) 820-7610

NPI assigned

Apr 30, 2022

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

Other identifiers 1

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": "1651276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651536000000",
    "number": "1790420164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1789 MADISON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100354537",
            "telephone_number": "646-820-7610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1789 MADISON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100354537",
            "telephone_number": "646-820-7610"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6863 108th St Apt 3H",
            "address_purpose": "LOCATION",
            "city": "Forest Hills",
            "state": "NY",
            "postal_code": "113752928",
            "country_code": "US",
            "telephone_number": "845-656-1302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENNACCHIA",
        "first_name": "STEPHANIE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-30",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "092232-01",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERSITY OF THE STATE OF NY EDUCATION DEPARTMENT OFFICE OF THE PROFESSIONS",
            "identifier": "092232-01",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark Eric Penn Jr.
• Michael R Penn, LCSW
• Stacey Michelle Penn, LMSW
• Christina M Penna
• Sara Penna, REGISTERED DIETITIAN
• Shani Pennant, MD
• Michelle Pennasilico
• Melanie F Pennella, RD, CSO, CDN
• Hannah Penner, M.S., CCC-SLP, CBIS
• Michael Pennett, M D

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2022; 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.