Provider Demographics
NPI:1912967829
Name:KRAL, RAYMONE BARBARA (PHD LMFT LP LICSW)
Entity Type:Individual
Prefix:DR
First Name:RAYMONE
Middle Name:BARBARA
Last Name:KRAL
Suffix:
Gender:F
Credentials:PHD LMFT LP LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 W SUPERIOR ST STE 625
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55802-1723
Mailing Address - Country:US
Mailing Address - Phone:218-606-1797
Mailing Address - Fax:651-925-0039
Practice Address - Street 1:324 W SUPERIOR ST STE 625
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55802-1723
Practice Address - Country:US
Practice Address - Phone:218-606-1797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-24
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN85261041C0700X
MN64106H00000X
MNLP2873103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39204400Medicaid
MN784350000Medicaid