Healthcare Provider Details

I. General information

NPI: 1366616377
Provider Name (Legal Business Name): PAULA D KRAUSE MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PAULA FRAASS

II. Dates (important events)

Enumeration Date: 04/22/2008
Last Update Date: 07/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 S PARKSIDE DRIVE
COLORADO SPRINGS CO
80910
US

IV. Provider business mailing address

559 VINCENT ST ATTN: 21 MDOS/SGOHF - FAP
PETERSON AFB CO
80914-1540
US

V. Phone/Fax

Practice location:
  • Phone: 719-572-6340
  • Fax: 719-447-4792
Mailing address:
  • Phone: 719-556-8943
  • Fax: 866-867-7926

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number840
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: