Provider Demographics
NPI:1023209905
Name:KREJCIER, KATHY ANN (LSW)
Entity Type:Individual
Prefix:MS
First Name:KATHY
Middle Name:ANN
Last Name:KREJCIER
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 1:4265 NORTHFIELD RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44128-2811
Mailing Address - Country:US
Mailing Address - Phone:216-378-9560
Mailing Address - Fax:216-378-9537
Practice Address - Street 1:4265 NORTHFIELD RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44128-2811
Practice Address - Country:US
Practice Address - Phone:216-378-9560
Practice Address - Fax:216-378-9537
Is Sole Proprietor?:No
Enumeration Date:2007-08-06
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS320561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical