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General NPI Number Information
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NPI Number | 1255017562
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Entity Type | Individual
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Provider Name | ELISE PENNINGTON LMSW
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Gender | Female
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Dates
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Enumeration Date | 06/22/2023
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Last Update Date | 06/27/2023
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Provider Practice Location Address
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Address Line | 904 WASHINGTON RD STE D
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City | WESTMINSTER
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State | MD
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Zip | 21157-5838
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Country | US
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Telephone | 443-789-6277
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Fax |
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Provider Business Mailing Address
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Address Line | 3345 BALTIMORE PIKE
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City | LITTLESTOWN
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State | PA
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Zip | 17340-9793
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Country | US
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Telephone | 717-688-5449
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 30286
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License Number State | MD
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