Provider Demographics
NPI:1508176322
Name:KRAEMER, LAUREN GROVES (LICSW)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:GROVES
Last Name:KRAEMER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:ANGELA
Other - Last Name:GROVES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:1200 1ST ST NE FL 9
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-7953
Mailing Address - Country:US
Mailing Address - Phone:202-442-5885
Mailing Address - Fax:202-698-2466
Practice Address - Street 1:1200 1ST ST NE FL 9
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-7953
Practice Address - Country:US
Practice Address - Phone:202-442-5885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-14
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500785271041C0700X, 1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC536001131Medicaid