Provider Demographics
NPI:1639237829
Name:KRAUSE, RICK J (MSW)
Entity Type:Individual
Prefix:
First Name:RICK
Middle Name:J
Last Name:KRAUSE
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4435 NW 36TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-2704
Mailing Address - Country:US
Mailing Address - Phone:405-948-8504
Mailing Address - Fax:405-848-0167
Practice Address - Street 1:4435 NW 36TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-2704
Practice Address - Country:US
Practice Address - Phone:405-948-8504
Practice Address - Fax:405-848-0167
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK10271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical