Doctor Name: | SUSAN GROOVER-VAN PELT |
NPI Number: | 1184047284 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LSW |
License Number: | SW127101 |
Business Practice Address: | 62 Plaza Ln Wellsboro, PA - 169011766 |
Business Phone Number: | 5707247142 |
Business Fax Number: | 5707246771 |
Mailing Address: | 1 W Main St, FLEETWOOD |
State: | PA |
Postal Code: | 195221323 |
Phone Number: | 6109440445 |
Fax Number: | 6109448834 |
NPI Enumeration Date: | 01/24/2014 |
NPI Last Update Date: | 01/24/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | SW127101 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |