Healthcare Provider Details

I. General information

NPI: 1821801515
Provider Name (Legal Business Name): KAITLYN FAYE KRANTZ LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATIE FAYE KRANTZ LCSW

II. Dates (important events)

Enumeration Date: 01/28/2025
Last Update Date: 04/07/2025
Certification Date: 04/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD
GAINESVILLE FL
32610-3003
US

IV. Provider business mailing address

1707 N MAIN STREET
GAINESVILLE FL
32609
US

V. Phone/Fax

Practice location:
  • Phone: 352-392-4541
  • Fax:
Mailing address:
  • Phone: 352-265-9593
  • Fax: 352-627-4197

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW23657
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: