Provider Demographics
NPI:1063035913
Name:KRAUS, MICHELLE J (LMSW)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:J
Last Name:KRAUS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 W 93RD ST APT 1H
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-7554
Mailing Address - Country:US
Mailing Address - Phone:917-374-4576
Mailing Address - Fax:
Practice Address - Street 1:123 W 93RD ST APT 1H
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-7554
Practice Address - Country:US
Practice Address - Phone:917-374-4576
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052885104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty