Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Penelope Nancy Lynn Pavlinovic, LICSW

Individual provider Clinical Social Worker · NPI 1174050629

Penelope Nancy Lynn Pavlinovic, LICSW is a Clinical Social Worker in Lacey, Washington. Qualified in 2009, 17 years ago. Practices as a sole proprietor, accepts Medicare assignment and offers telehealth. Licensed in Washington.

Years since qualifying
17
Licensed in
WA
In the registry since
2017
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

677 Woodland Square Loop SE
Lacey, WA 98503-1000
Phone: (206) 979-4005
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 60606294 (WA)

Record details

NPI number1174050629
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW
Sole proprietorYes
NPI enumeratedMay 16, 2017
Last updated in NPPESJuly 22, 2024
Certification dateJuly 21, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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