Provider Demographics
NPI:1689230344
Name:CRAMER, MADELINE JANE
Entity Type:Individual
Prefix:MRS
First Name:MADELINE
Middle Name:JANE
Last Name:CRAMER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9220 CYCLONE SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64064-2611
Mailing Address - Country:US
Mailing Address - Phone:816-286-4803
Mailing Address - Fax:888-827-4136
Practice Address - Street 1:9220 CYCLONE SCHOOL RD
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64064-2611
Practice Address - Country:US
Practice Address - Phone:816-286-4803
Practice Address - Fax:888-827-4136
Is Sole Proprietor?:No
Enumeration Date:2019-05-17
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017027560101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1972839587OtherNPI
MO2017027560OtherMO LPC LICENSE