Provider Demographics
NPI:1639232325
Name:KRAUSE, STUART (PHD)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:
Last Name:KRAUSE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:643 NORTHERN LIGHTS BLVD
Mailing Address - Street 2:APT 1311
Mailing Address - City:BOX ELDER
Mailing Address - State:SD
Mailing Address - Zip Code:57719-6109
Mailing Address - Country:US
Mailing Address - Phone:605-791-0666
Mailing Address - Fax:
Practice Address - Street 1:550 N 5TH ST
Practice Address - Street 2:STE 321
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-1375
Practice Address - Country:US
Practice Address - Phone:605-791-0666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY372103TC0700X
SD511103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical