Provider Demographics
NPI:1457739674
Name:PENN, BARBARA (LCSW, CCDP-D)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:PENN
Suffix:
Gender:F
Credentials:LCSW, CCDP-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:196 HAMILL SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:BOLIVAR
Mailing Address - State:PA
Mailing Address - Zip Code:15923-2525
Mailing Address - Country:US
Mailing Address - Phone:724-238-8441
Mailing Address - Fax:724-238-3748
Practice Address - Street 1:196 HAMILL SCHOOL RD
Practice Address - Street 2:
Practice Address - City:BOLIVAR
Practice Address - State:PA
Practice Address - Zip Code:15923-2525
Practice Address - Country:US
Practice Address - Phone:724-238-8441
Practice Address - Fax:724-238-3748
Is Sole Proprietor?:No
Enumeration Date:2015-05-07
Last Update Date:2015-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0182691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical