Individual provider Active NPI

Christine Joanne Penguino, LMSW

  • Clinical Social Worker
  • Decatur, GA
National Provider Identifier
1962036798
Registry record updated Sep 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
MSW009254 Issued in GA
Practice address
120 E Trinity PL
Decatur, GA 30030-3302
Phone
(404) 378-2300
NPI assigned
Mar 2, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X MSW009254 GA Primary

Addresses

Primary practice location

120 E Trinity PL
Decatur, GA 30030-3302

Mailing address

1510 Woodland Cir SE
Atlanta, GA 30316-3160

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240202000996 GA Practitioner - Clinical Social Worker 9537512892 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MSW009254GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Joseph'S Mercy Care Services, Inc. Current Accepting new patients
Emory Medical Care Foundation Inc CurrentSince Sep 16, 2025 Accepting new patients
Saint Joseph'S Mercy Care Services Inc Current Accepting new patients
Saint Joseph'S Mercy Care Services, Inc. CurrentSince Dec 20, 2023 Accepting new patients
Emory Medical Care Foundation Inc CurrentSince Sep 16, 2025 Accepting new patients
Saint Joseph'S Mercy Care Services, Inc. CurrentSince Dec 20, 2023 Accepting new patients

Locations

1300 Joseph E Boone Blvd NW
Atlanta, GA 30314
Phone (404) 952-1201

424 Decatur St SE
Atlanta, GA 30312
Phone (678) 843-8500

275 Pryor St SW
Atlanta, GA 30303
Phone (678) 843-8840

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

5134 Peachtree Rd
Chamblee, GA 30341
Phone (678) 872-7100

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1583107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1962036798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 WOODLAND CIR SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303163160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E TRINITY PL",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300303302",
            "telephone_number": "404-378-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENGUINO",
        "first_name": "CHRISTINE",
        "middle_name": "JOANNE",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-02",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "MSW009254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

Verify at the official NPI Registry.