Provider Demographics
NPI:1851349765
Name:KRAMER, CHARLES 'SID' WILLIAM (LCSW)
Entity Type:Individual
Prefix:MR
First Name:CHARLES 'SID'
Middle Name:WILLIAM
Last Name:KRAMER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:633 HIDDEN HOLLOW CIR
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-4286
Mailing Address - Country:US
Mailing Address - Phone:405-640-3554
Mailing Address - Fax:
Practice Address - Street 1:3280 MARSHALL AVE
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-8028
Practice Address - Country:US
Practice Address - Phone:405-640-3554
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK11441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical