Provider Demographics
NPI:1558759951
Name:PENDER, SENECA (LICSW)
Entity Type:Individual
Prefix:MR
First Name:SENECA
Middle Name:
Last Name:PENDER
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 E BOLTON ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31401-5920
Mailing Address - Country:US
Mailing Address - Phone:443-480-7503
Mailing Address - Fax:
Practice Address - Street 1:408 E BOLTON ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31401-5920
Practice Address - Country:US
Practice Address - Phone:912-447-5530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-07
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RICSW017581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical