Provider Demographics
NPI:1811788581
Name:PENN, GILLIAN GEORGETTE (LCSW)
Entity type:Individual
Prefix:
First Name:GILLIAN
Middle Name:GEORGETTE
Last Name:PENN
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 1:28889 ORANGE BERRY DR
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33543-7422
Mailing Address - Country:US
Mailing Address - Phone:908-461-6418
Mailing Address - Fax:908-461-6418
Practice Address - Street 1:28889 ORANGE BERRY DR
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33543-7422
Practice Address - Country:US
Practice Address - Phone:908-461-6418
Practice Address - Fax:908-461-6418
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-13
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW181941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical