Provider Demographics
NPI:1962063404
Name:PENNETTI, ABBIE ROSEMARY (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ABBIE
Middle Name:ROSEMARY
Last Name:PENNETTI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ABBIE
Other - Middle Name:ROSEMARY
Other - Last Name:BARSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:12401 E 17TH AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045-2548
Mailing Address - Country:US
Mailing Address - Phone:207-848-7234
Mailing Address - Fax:
Practice Address - Street 1:1635 AURORA CT STE &5200
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-2541
Practice Address - Country:US
Practice Address - Phone:720-848-2080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-25
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
COCSW.099259421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical