Provider Demographics
NPI:1346599586
Name:ORAZEM, KRISTEN E (MSW, LICSW)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:E
Last Name:ORAZEM
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6550 YORK AVE. SOUTH
Mailing Address - Street 2:SUITE 417
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435
Mailing Address - Country:US
Mailing Address - Phone:612-504-1832
Mailing Address - Fax:612-807-1773
Practice Address - Street 1:6550 YORK AVE. SOUTH
Practice Address - Street 2:SUITE 417
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435
Practice Address - Country:US
Practice Address - Phone:612-504-1832
Practice Address - Fax:612-807-1773
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-04
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN186951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical