Provider Demographics
NPI:1710401468
Name:KRAUSE, JUDY ANN (LPC-IT, CSW, SAC-IT)
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:ANN
Last Name:KRAUSE
Suffix:
Gender:F
Credentials:LPC-IT, CSW, SAC-IT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14301 COUNTY HIGHWAY B
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:WI
Mailing Address - Zip Code:54656-4859
Mailing Address - Country:US
Mailing Address - Phone:608-269-8600
Mailing Address - Fax:
Practice Address - Street 1:14301 COUNTY HIGHWAY B
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:WI
Practice Address - Zip Code:54656-4859
Practice Address - Country:US
Practice Address - Phone:608-269-8633
Practice Address - Fax:608-269-8935
Is Sole Proprietor?:No
Enumeration Date:2017-08-02
Last Update Date:2017-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor