Provider Demographics
NPI:1851573208
Name:SID KRAMER, LSW PC
Entity Type:Organization
Organization Name:SID KRAMER, LSW PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SID
Authorized Official - Middle Name:
Authorized Official - Last Name:KRAMER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:405-640-3554
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:405-285-2178
Practice Address - Street 1:3601 N CLASSEN BLVD
Practice Address - Street 2:SUITE 106
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73118-3231
Practice Address - Country:US
Practice Address - Phone:405-640-3554
Practice Address - Fax:405-285-2178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-28
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1144261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)