Kristianna Penman, MSW
Social Worker, Clinical in Medford, MA. Individual provider (NPI-1).
NPI number1376793554
StatusActive
Last updated in NPPESJan 26, 2020
Details
- NPI
- 1376793554
- Entity type
- Individual (NPI-1)
- Name
- Kristianna Penman
- Credential
- MSW
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 24, 2008
- Certification date
- Jan 26, 2020
- Last updated
- Jan 26, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 117051 | MA | Yes |
Practice location
10 Cabot RdSuite 209
Medford, MA 02155-5177
Phone 617-835-7256 · Fax 781-395-0198
Mailing address
10 Cabot RdSuite 209
Medford, MA 02155-5177
Phone 617-835-7256 · Fax 781-395-0198
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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