Provider Demographics
NPI:1700930062
Name:DEGROOT, LINETTE RENEE (BA)
Entity Type:Individual
Prefix:
First Name:LINETTE
Middle Name:RENEE
Last Name:DEGROOT
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:LINETTE
Other - Middle Name:RENEE
Other - Last Name:SHELLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LMHCA
Mailing Address - Street 1:900 SHERIDAN RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98310-2701
Mailing Address - Country:US
Mailing Address - Phone:360-415-5866
Mailing Address - Fax:
Practice Address - Street 1:900 SHERIDAN RD
Practice Address - Street 2:SUITE 106
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98310-2701
Practice Address - Country:US
Practice Address - Phone:360-415-5866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2014-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60245291101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor