Provider Demographics
NPI:1134276371
Name:KRAGER, ARLENE LYNN (MA, LPC, CAC-II, SAP)
Entity type:Individual
Prefix:MS
First Name:ARLENE
Middle Name:LYNN
Last Name:KRAGER
Suffix:
Gender:F
Credentials:MA, LPC, CAC-II, SAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 W KNOX ST
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:MI
Mailing Address - Zip Code:48612-8124
Mailing Address - Country:US
Mailing Address - Phone:989-435-3309
Mailing Address - Fax:989-435-3384
Practice Address - Street 1:201 S ROSS ST
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:MI
Practice Address - Zip Code:48612-8113
Practice Address - Country:US
Practice Address - Phone:989-435-3309
Practice Address - Fax:989-435-3384
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI200329101YA0400X
MI6401003258101Y00000X
MI11017101YA0400X
MI260007101YA0400X
MI12016101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor