Provider Demographics
NPI:1609114982
Name:CRAMER, KRISTY NICOLE (LPC)
Entity Type:Individual
Prefix:
First Name:KRISTY
Middle Name:NICOLE
Last Name:CRAMER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3229 CENTRAL ST APT 13
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-1322
Mailing Address - Country:US
Mailing Address - Phone:303-229-0285
Mailing Address - Fax:913-768-6609
Practice Address - Street 1:11695 S BLACKBOB RD
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-1058
Practice Address - Country:US
Practice Address - Phone:913-768-6606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-22
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2433101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional