Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. LONNIE DALE PENROD, MA, MSW, D.MIN, LCSW
Active Sole ProprietorDR. LONNIE DALE PENROD, MA, MSW, D.MIN, LCSW is a Clinical Social Worker healthcare provider located in INDIAN MOUND, Tennessee. NPI 1053992214 is currently active in the NPPES registry. Verify at CMS.
Clinical Social Worker · INDIAN MOUND, TN
Registration Details
- NPI Number
- 1053992214
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 19, 2021 (5.3242245760805 yrs)
- Last Updated
- Apr 19, 2021
- License
-
6195 (TN)
- Sole Proprietor
- Yes
Practice Information
- Address
-
109 ROOSTER STINDIAN MOUND, TN, 370795302Browse TN providers · Browse ZIP 37079
- Phone
- 9319804551
- Primary Specialty
-
Clinical Social Worker
1041C0700X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.