Provider Demographics
NPI:1356475677
Name:KRATKA, DAVID B (MS, LCSW)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:B
Last Name:KRATKA
Suffix:
Gender:M
Credentials:MS, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 COURT ST
Mailing Address - Street 2:APT. 4C
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-5151
Mailing Address - Country:US
Mailing Address - Phone:973-984-1747
Mailing Address - Fax:
Practice Address - Street 1:300 W MAIN ST
Practice Address - Street 2:
Practice Address - City:ROCKAWAY
Practice Address - State:NJ
Practice Address - Zip Code:07866-3309
Practice Address - Country:US
Practice Address - Phone:973-984-1747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC008563001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical