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NPI Code Detail

MEDICARE: LEONARD R PENNISI LMSW

MEDICARE: LEONARD R PENNISI LMSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker6801109222MI

General Provider Information

NPI Number : 1700343464
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEONARD R PENNISI LMSW
Provider Business Mailing Address
First Line : 18200 OAKWOOD BLVD
Second Line :
City : DEARBORN
State : MI
Zip : 48124-5025
Country : US
Telephone Number : 947-524-2760
Fax Number :
Provider Business Practice Location Address
First Line : 18200 OAKWOOD BLVD
Second Line :
City : DEARBORN
State : MI
Zip : 48124-5025
Country : US
Telephone Number : 947-524-2760
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2019
Last Update Date : 01/29/2026

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Directions to “ LEONARD R PENNISI LMSW” Practice Location

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