Susanne Groenendaal, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW-000305-L Issued in PA

Practice address

119 S Burrowes St
State College, PA 16801-3894

Phone

(814) 441-7456

Fax

(814) 238-1875

NPI assigned

Jul 15, 2005

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613347200000",
    "number": "1265431936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 S BURROWES ST",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168013894",
            "telephone_number": "814-441-7456",
            "fax_number": "814-238-1875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 S BURROWES ST",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168013894",
            "telephone_number": "814-441-7456",
            "fax_number": "814-238-1875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROENENDAAL",
        "first_name": "SUSANNE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-15",
        "last_updated": "2021-02-15",
        "certification_date": "2021-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW-000305-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007032703",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "010988",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura Megan Gregor, LCSW
• Ginger Marlene Grieco, DDS
• Lester C Griel III, CRNP
• Kristen M Grine, DO
• Megan Muir Grivas, LPC
• Sarah Emili Gross, PA-C
• Jennifer P Grove, LSW
• Michelle L Grove
• Anveshi Gabriela Guha, MD
• Guiding Light Health PC

• Clinical Social Worker in State College, PA
• Providers in State College, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.