Provider Demographics
NPI:1770889628
Name:KRAUEL, KRISTEN SHELENA (LCSW)
Entity type:Individual
Prefix:MS
First Name:KRISTEN
Middle Name:SHELENA
Last Name:KRAUEL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 MASONIC AVE.
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118
Mailing Address - Country:US
Mailing Address - Phone:415-933-7312
Mailing Address - Fax:415-757-0254
Practice Address - Street 1:23 MASONIC AVE.
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118
Practice Address - Country:US
Practice Address - Phone:415-933-7312
Practice Address - Fax:415-757-0254
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-09
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
CA1041C0700X
CALPCC1201101YP2500X
CALCSW272591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional