Provider Demographics
NPI:1346742574
Name:GROFF, MICHELLE RENEE (LCSW)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:RENEE
Last Name:GROFF
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 1:136 SPRUCE AVE
Mailing Address - Street 2:
Mailing Address - City:WESTVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08093-1118
Mailing Address - Country:US
Mailing Address - Phone:856-371-5345
Mailing Address - Fax:
Practice Address - Street 1:1930 MARLTON PIKE E STE V105
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-4101
Practice Address - Country:US
Practice Address - Phone:856-751-0505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-04
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC058996001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical