Provider Demographics
NPI:1508962770
Name:KRAFT, ADRIENNE DIANNE (MA, LCSW, LISAC)
Entity Type:Individual
Prefix:MS
First Name:ADRIENNE
Middle Name:DIANNE
Last Name:KRAFT
Suffix:
Gender:F
Credentials:MA, LCSW, LISAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7557 N DREAMY DRAW DR
Mailing Address - Street 2:UNIT 284
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-4651
Mailing Address - Country:US
Mailing Address - Phone:602-997-9877
Mailing Address - Fax:
Practice Address - Street 1:7557 N DREAMY DRAW DR
Practice Address - Street 2:UNIT 284
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-4651
Practice Address - Country:US
Practice Address - Phone:602-997-9877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLISAC-11516101YA0400X
AZLCSW-34881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical