Provider Demographics
NPI:1427187541
Name:KRAMER, KRISTEN A (LICSW)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:A
Last Name:KRAMER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 SHADY LN
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:RI
Mailing Address - Zip Code:02915-2430
Mailing Address - Country:US
Mailing Address - Phone:401-433-1146
Mailing Address - Fax:
Practice Address - Street 1:140 PARK ST
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-3064
Practice Address - Country:US
Practice Address - Phone:508-222-7525
Practice Address - Fax:508-223-4145
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1106271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1309161Medicaid
RI27426-7OtherBLUE CROSS BLUE SHIELD RI