MEDICARE: NANCY ANN PENA LCSW

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
1	104100000X	Social Worker
2	1041C0700X	Clinical Social Worker	253113	KY
3	1041C0700X	Clinical Social Worker	65706	TX
4	1041C0700X	Clinical Social Worker	SW16966	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	65706	OTHER	TX	LICENSE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770887838
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY ANN PENA LCSW

Provider Business Mailing Address
First Line	:	18166 PARROT RD
Second Line	:
City	:	WEEKI WACHEE
State	:	FL
Zip	:	34614-0318
Country	:	US
Telephone Number	:	580-917-1379
Fax Number	:

Provider Business Practice Location Address
First Line	:	18166 PARROT RD
Second Line	:
City	:	WEEKI WACHEE
State	:	FL
Zip	:	34614-0318
Country	:	US
Telephone Number	:	727-378-2287
Fax Number	:	727-645-4798

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2011
Last Update Date	:	04/28/2025

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Directions to “ NANCY ANN PENA LCSW” Practice Location

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