Provider Demographics
NPI:1407060163
Name:KRAFT, JUDITH STORMS (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:STORMS
Last Name:KRAFT
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 1:5000 N OCEAN BLVD
Mailing Address - Street 2:A-17
Mailing Address - City:BRINY BREEZES
Mailing Address - State:FL
Mailing Address - Zip Code:33435-7341
Mailing Address - Country:US
Mailing Address - Phone:561-271-9111
Mailing Address - Fax:561-243-1988
Practice Address - Street 1:5000 N OCEAN BLVD
Practice Address - Street 2:
Practice Address - City:BRINY BREEZES
Practice Address - State:FL
Practice Address - Zip Code:33435-7341
Practice Address - Country:US
Practice Address - Phone:561-271-9111
Practice Address - Fax:561-243-1988
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 83261041C0700X
MA1054671041C0700X
CT0046061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical