Provider Demographics
NPI:1114378247
Name:PENMAN, NANCY
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:
Last Name:PENMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:NANCY
Other - Middle Name:
Other - Last Name:SCHOCHETMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:29699 SOUTHFIELD RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-2038
Mailing Address - Country:US
Mailing Address - Phone:248-559-5000
Mailing Address - Fax:248-559-0773
Practice Address - Street 1:29699 SOUTHFIELD RD
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-2038
Practice Address - Country:US
Practice Address - Phone:248-559-5000
Practice Address - Fax:248-559-0773
Is Sole Proprietor?:No
Enumeration Date:2016-06-30
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801035848104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker