Provider Demographics
NPI:1437587425
Name:KRAMER, MELISSA R (LCSW)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:R
Last Name:KRAMER
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 1:85 ROOSEVELT CIR E
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-5824
Mailing Address - Country:US
Mailing Address - Phone:609-338-9574
Mailing Address - Fax:
Practice Address - Street 1:115 MAPLE AVE STE 201
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-1753
Practice Address - Country:US
Practice Address - Phone:732-443-0331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-29
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY088035-1104100000X
NY0858971041C0700X
NJ44SC057864001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker