Provider Demographics
NPI:1740338938
Name:KRUGER, ELIZABETH LOUISE (LCSW-R)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:LOUISE
Last Name:KRUGER
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:261 GLEED AVE
Mailing Address - Street 2:
Mailing Address - City:EAST AURORA
Mailing Address - State:NY
Mailing Address - Zip Code:14052-2905
Mailing Address - Country:US
Mailing Address - Phone:716-655-4292
Mailing Address - Fax:
Practice Address - Street 1:261 GLEED AVE
Practice Address - Street 2:
Practice Address - City:EAST AURORA
Practice Address - State:NY
Practice Address - Zip Code:14052-2905
Practice Address - Country:US
Practice Address - Phone:716-655-4292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR057693-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical