Provider Demographics
NPI:1770918229
Name:GROEBEL, JOANNA V (MA, R-DMT, LPC)
Entity type:Individual
Prefix:MS
First Name:JOANNA
Middle Name:V
Last Name:GROEBEL
Suffix:
Gender:F
Credentials:MA, R-DMT, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1052 FRIEDENSBURG RD
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19606-9218
Mailing Address - Country:US
Mailing Address - Phone:610-370-5713
Mailing Address - Fax:
Practice Address - Street 1:641 PENN AVE REAR
Practice Address - Street 2:
Practice Address - City:WEST READING
Practice Address - State:PA
Practice Address - Zip Code:19611-1161
Practice Address - Country:US
Practice Address - Phone:610-374-8020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-03
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC006985101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional