Provider Demographics
NPI:1164878252
Name:KRANKEL, DEANNA (LCSW)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:
Last Name:KRANKEL
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 1:102 GAYLORD DR
Mailing Address - Street 2:
Mailing Address - City:COLLINSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62234-4825
Mailing Address - Country:US
Mailing Address - Phone:618-979-3877
Mailing Address - Fax:314-344-7736
Practice Address - Street 1:12303 DEPAUL DRIVE
Practice Address - Street 2:ST. VINCENT'S BEHAVIORAL HEATLH SERVICES
Practice Address - City:BRIDGETON
Practice Address - State:MO
Practice Address - Zip Code:63044
Practice Address - Country:US
Practice Address - Phone:314-344-6560
Practice Address - Fax:314-344-7736
Is Sole Proprietor?:No
Enumeration Date:2016-05-09
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0053591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical