Provider Demographics
NPI:1760674576
Name:TIMMONS-LEMMERMAN, PENNY L (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:PENNY
Middle Name:L
Last Name:TIMMONS-LEMMERMAN
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6501 N CHARLES ST
Mailing Address - Street 2:POWER PLANT, ROOM PH291
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21204-6819
Mailing Address - Country:US
Mailing Address - Phone:410-938-4668
Mailing Address - Fax:410-938-5131
Practice Address - Street 1:3346 PAPER MILL RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:MD
Practice Address - Zip Code:21131-1419
Practice Address - Country:US
Practice Address - Phone:410-938-4668
Practice Address - Fax:410-938-5131
Is Sole Proprietor?:No
Enumeration Date:2007-08-15
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD119861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD11986OtherLCSW-C