Provider Demographics
NPI:1043242761
Name:KRAMER, JEFFREY (LMHC)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:KRAMER
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 GRAND AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50312-5300
Mailing Address - Country:US
Mailing Address - Phone:515-689-3071
Mailing Address - Fax:
Practice Address - Street 1:2600 GRAND AVE STE 110
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50312-5300
Practice Address - Country:US
Practice Address - Phone:515-689-3071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2016-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00151101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0074583Medicaid