Provider Demographics
NPI:1649892993
Name:KRAUSE, CARLA JAN (LPCA, MAC)
Entity type:Individual
Prefix:MS
First Name:CARLA
Middle Name:JAN
Last Name:KRAUSE
Suffix:
Gender:F
Credentials:LPCA, MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 MILL RACE DR
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-3128
Mailing Address - Country:US
Mailing Address - Phone:919-699-2210
Mailing Address - Fax:
Practice Address - Street 1:216 MILL RACE DR
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-3128
Practice Address - Country:US
Practice Address - Phone:919-699-2210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-09
Last Update Date:2020-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCKRAU-N9FCM6101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty