Provider Demographics
NPI:1699397265
Name:KRAUS, ALEXIS DANIELLE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ALEXIS
Middle Name:DANIELLE
Last Name:KRAUS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ALEXIS
Other - Middle Name:DANIELLE
Other - Last Name:PANICO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3005 N RACINE AVE APT 1F
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-6692
Mailing Address - Country:US
Mailing Address - Phone:847-331-8482
Mailing Address - Fax:
Practice Address - Street 1:3005 N RACINE AVE APT 1F
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-6692
Practice Address - Country:US
Practice Address - Phone:847-331-8482
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-17
Last Update Date:2020-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0208101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical