Provider Demographics
NPI:1831247022
Name:KRAMER, CHARLES H III (LMSW, BCD)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:H
Last Name:KRAMER
Suffix:III
Gender:M
Credentials:LMSW, BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 N 1ST ST STE 106
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-1354
Mailing Address - Country:US
Mailing Address - Phone:734-663-4553
Mailing Address - Fax:
Practice Address - Street 1:117 N 1ST ST
Practice Address - Street 2:STE. 106
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-1354
Practice Address - Country:US
Practice Address - Phone:734-662-2144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-06
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010190101041C0700X
MI4101005791106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist