Provider Demographics
NPI:1760535215
Name:KRAMER, LINDA M (LICSW)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:M
Last Name:KRAMER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 SYMMES ST
Mailing Address - Street 2:
Mailing Address - City:ROSLINDALE
Mailing Address - State:MA
Mailing Address - Zip Code:02131-1643
Mailing Address - Country:US
Mailing Address - Phone:617-327-6156
Mailing Address - Fax:617-327-6156
Practice Address - Street 1:1415 BEACON ST
Practice Address - Street 2:SUITE 306
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-4816
Practice Address - Country:US
Practice Address - Phone:617-731-4488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10240731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP07563OtherBLUE CROSS BLUE SHIELD
MAKRP21247Medicare ID - Type Unspecified