Provider Demographics
NPI:1093729345
Name:ZIELINSKI, PENNY LEE (LCSW)
Entity Type:Individual
Prefix:
First Name:PENNY
Middle Name:LEE
Last Name:ZIELINSKI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 CIRCLE LK
Mailing Address - Street 2:
Mailing Address - City:ROCKPORT
Mailing Address - State:TX
Mailing Address - Zip Code:78382-7986
Mailing Address - Country:US
Mailing Address - Phone:361-729-2026
Mailing Address - Fax:
Practice Address - Street 1:1515 N LIVEOAK ST
Practice Address - Street 2:
Practice Address - City:ROCKPORT
Practice Address - State:TX
Practice Address - Zip Code:78382-3024
Practice Address - Country:US
Practice Address - Phone:361-463-7160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0176371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical