Provider Demographics
NPI:1790067023
Name:DRUMM, KRISTINA ELKE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KRISTINA
Middle Name:ELKE
Last Name:DRUMM
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2908 NW 6TH TER
Mailing Address - Street 2:
Mailing Address - City:WILTON MANORS
Mailing Address - State:FL
Mailing Address - Zip Code:33311-2425
Mailing Address - Country:US
Mailing Address - Phone:954-549-0263
Mailing Address - Fax:
Practice Address - Street 1:1480 SW 9TH AVE
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33315-1375
Practice Address - Country:US
Practice Address - Phone:954-549-0263
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-13
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW104751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical