Provider Demographics
NPI:1457077513
Name:ANNELIESE KRANZ LCPC PLLC
Entity type:Organization
Organization Name:ANNELIESE KRANZ LCPC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANNELIESE
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:KRANZ
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:717-385-9214
Mailing Address - Street 1:1613 CHURCH STREET
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201
Mailing Address - Country:US
Mailing Address - Phone:717-385-9214
Mailing Address - Fax:
Practice Address - Street 1:1613 CHURCH STREET
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201
Practice Address - Country:US
Practice Address - Phone:717-385-9214
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-19
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty