Provider Demographics
NPI:1841917556
Name:PENNE, CHELSEA LANE (LMSW)
Entity type:Individual
Prefix:MRS
First Name:CHELSEA
Middle Name:LANE
Last Name:PENNE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:LANE
Other - Last Name:WARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14535 W INDIAN SCHOOL RD STE 120
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85395-9282
Mailing Address - Country:US
Mailing Address - Phone:602-550-9618
Mailing Address - Fax:
Practice Address - Street 1:14535 W INDIAN SCHOOL RD STE 120
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85395-9282
Practice Address - Country:US
Practice Address - Phone:602-550-9618
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-24
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMSW-172021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical