Provider Demographics
NPI:1275655474
Name:KRAMER, JILL ANNE (MSSW, LICSW)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:ANNE
Last Name:KRAMER
Suffix:
Gender:F
Credentials:MSSW, LICSW
Other - Prefix:
Other - First Name:JILL
Other - Middle Name:ANNE
Other - Last Name:WHITTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSSW, LICSW
Mailing Address - Street 1:6550 YORK AVE S STE 300
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-2334
Mailing Address - Country:US
Mailing Address - Phone:612-251-1789
Mailing Address - Fax:952-322-7184
Practice Address - Street 1:6550 YORK AVE S STE 300
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435
Practice Address - Country:US
Practice Address - Phone:612-251-1789
Practice Address - Fax:952-322-7184
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2018-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN14541104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker