Provider Demographics
NPI:1790511582
Name:KRATZEL, SHELBY ANGELINA (LCSWA, CPSS)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:ANGELINA
Last Name:KRATZEL
Suffix:
Gender:F
Credentials:LCSWA, CPSS
Other - Prefix:
Other - First Name:SHELBY
Other - Middle Name:ANGELINA
Other - Last Name:WONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:113 GODWIN CT
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27330-9743
Mailing Address - Country:US
Mailing Address - Phone:984-528-0308
Mailing Address - Fax:
Practice Address - Street 1:4000 WAKE FOREST RD STE 280
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-6859
Practice Address - Country:US
Practice Address - Phone:984-212-0028
Practice Address - Fax:919-591-0167
Is Sole Proprietor?:No
Enumeration Date:2024-09-10
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0192651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical