Provider Demographics
NPI:1871813477
Name:KREBS, GRETCHEN M (LCSW)
Entity type:Individual
Prefix:
First Name:GRETCHEN
Middle Name:M
Last Name:KREBS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 WILLIAM ST
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-9138
Mailing Address - Country:US
Mailing Address - Phone:717-881-1530
Mailing Address - Fax:
Practice Address - Street 1:118 CARLISLE ST STE 304
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-2487
Practice Address - Country:US
Practice Address - Phone:717-467-1116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-04
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0181931041C0700X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical