Provider Demographics
NPI:1558824847
Name:KRAMER, TYLER JOSEPH (MA, LPCA)
Entity Type:Individual
Prefix:
First Name:TYLER
Middle Name:JOSEPH
Last Name:KRAMER
Suffix:
Gender:M
Credentials:MA, LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8600 SAM FURR RD STE 260
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-6182
Mailing Address - Country:US
Mailing Address - Phone:704-960-3619
Mailing Address - Fax:980-689-2738
Practice Address - Street 1:8600 SAM FURR RD STE 260
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-6182
Practice Address - Country:US
Practice Address - Phone:704-960-3619
Practice Address - Fax:980-689-2738
Is Sole Proprietor?:No
Enumeration Date:2019-04-12
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA14142101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional