Groenendaal, Susanne
Groenendaal, Susanne is an sole proprietor health care provider with primary practice located at 119 S Burrowes St , State College PA 16801-3894. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Groenendaal, Susanne can be contacted via phone (814) 441-7456.Contact Information
Primary practice address
119 S Burrowes St
State College PA 16801-3894
Phone: (814) 441-7456
Fax: (814) 238-1875
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | CW-000305-L | Pennsylvania |
Profile Details
| NPI number | 1265431936 |
|---|---|
| LBN Legal business name | Groenendaal, Susanne |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 15th, 2005 |
| Last updated | Feb 15th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1265431936 | NPPES |
| Pennsylvania | MEDICAID | 007032703 | |
| Pennsylvania | Other | 010988 |
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