Provider Demographics
NPI:1942026919
Name:VAN DER GROEF, REBECCA (LSW)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:
Last Name:VAN DER GROEF
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 ORPHANAGE RD
Mailing Address - Street 2:
Mailing Address - City:LITTLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17340-9729
Mailing Address - Country:US
Mailing Address - Phone:717-359-7148
Mailing Address - Fax:717-359-2600
Practice Address - Street 1:815 ORPHANAGE RD
Practice Address - Street 2:
Practice Address - City:LITTLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:17340-9729
Practice Address - Country:US
Practice Address - Phone:717-359-7148
Practice Address - Fax:717-359-2600
Is Sole Proprietor?:No
Enumeration Date:2024-11-25
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW124302104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker