Provider Demographics
NPI:1134181290
Name:KAUFMAN, PENNI (LCSW)
Entity type:Individual
Prefix:
First Name:PENNI
Middle Name:
Last Name:KAUFMAN
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 1:120 MAIN ST STE 105
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-2707
Mailing Address - Country:US
Mailing Address - Phone:603-953-4145
Mailing Address - Fax:
Practice Address - Street 1:1465 HOOKSETT RD UNIT 219
Practice Address - Street 2:
Practice Address - City:HOOKSETT
Practice Address - State:NH
Practice Address - Zip Code:03106-1829
Practice Address - Country:US
Practice Address - Phone:603-882-2115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-04
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEKAMM7790Medicare ID - Type Unspecified