Provider Demographics
NPI:1770947731
Name:KRAMER, SUSAN (LPCC)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:KRAMER
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:
Other - Last Name:KRAMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4225 TECHNOLOGY DR NW
Mailing Address - Street 2:
Mailing Address - City:BEMIDJI
Mailing Address - State:MN
Mailing Address - Zip Code:56601-5118
Mailing Address - Country:US
Mailing Address - Phone:218-751-0282
Mailing Address - Fax:218-751-0870
Practice Address - Street 1:4225 TECHNOLOGY DR NW
Practice Address - Street 2:
Practice Address - City:BEMIDJI
Practice Address - State:MN
Practice Address - Zip Code:56601-5118
Practice Address - Country:US
Practice Address - Phone:218-751-0282
Practice Address - Fax:218-751-0870
Is Sole Proprietor?:No
Enumeration Date:2016-04-06
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC01159101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health