Healthcare Provider Details

I. General information

NPI: 1316607732
Provider Name (Legal Business Name): SARAH ELIZABETH PENLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/27/2021
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 ALFRED ST
BIDDEFORD ME
04005-3741
US

IV. Provider business mailing address

419 ALFRED ST
BIDDEFORD ME
04005-3747
US

V. Phone/Fax

Practice location:
  • Phone: 207-494-8010
  • Fax: 207-494-8471
Mailing address:
  • Phone: 207-494-2794
  • Fax: 207-494-8471

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC23595
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: