MEDICARE: DR. SARAH Y. KRAKAUER PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	0810001912	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	282496	OTHER	VA	ANTHEM
2	056020	OTHER	VA	VALUEOPTIONS

General Provider Information

NPI Number	:	1538222344
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SARAH Y. KRAKAUER PSY.D.

Provider Business Mailing Address
First Line	:	333 MCLAWS CIR
Second Line	:	SUITE 1
City	:	WILLIAMSBURG
State	:	VA
Zip	:	23185-6339
Country	:	US
Telephone Number	:	757-220-4943
Fax Number	:

Provider Business Practice Location Address
First Line	:	333 MCLAWS CIR
Second Line	:	SUITE 1
City	:	WILLIAMSBURG
State	:	VA
Zip	:	23185-6339
Country	:	US
Telephone Number	:	757-220-4943
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/19/2006
Last Update Date	:	07/13/2007

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