Provider Demographics
NPI:1902076367
Name:PENARANDA, MARCELA (MSW)
Entity Type:Individual
Prefix:
First Name:MARCELA
Middle Name:
Last Name:PENARANDA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 E 50TH ST
Mailing Address - Street 2:APT 106
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-7517
Mailing Address - Country:US
Mailing Address - Phone:212-752-4596
Mailing Address - Fax:
Practice Address - Street 1:20 LANGNER LN
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:CT
Practice Address - Zip Code:06883-1231
Practice Address - Country:US
Practice Address - Phone:203-341-8891
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-01
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0060431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical