Provider Demographics
NPI:1942245493
Name:KRAWCZYK, GAIL J (LCSW)
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:J
Last Name:KRAWCZYK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 25
Mailing Address - Street 2:
Mailing Address - City:DE PERE
Mailing Address - State:WI
Mailing Address - Zip Code:54115-0025
Mailing Address - Country:US
Mailing Address - Phone:920-983-9401
Mailing Address - Fax:920-983-9402
Practice Address - Street 1:2631 PACKERLAND DR
Practice Address - Street 2:SUITE 104C
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54313-4130
Practice Address - Country:US
Practice Address - Phone:920-965-7701
Practice Address - Fax:920-497-4956
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2009-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6723-123104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker