Individual
MR. FREDERICK WILLIAM PENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LSW
Contact information
Practice address
2100 N MAIN ST # 304, CROWN POINT, IN 46307-1877
(574) 546-1900
(574) 546-1999
Mailing address
4911 PARKSIDE AVE N, PHILADELPHIA, PA 19131-2609
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
SW130934
PA
1041C0700X
Clinical Social Worker
Primary
34011893A
IN
Other
Enumeration date
03/27/2024
Last updated
01/20/2026
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