Healthcare Provider Details

I. General information

NPI: 1063199347
Provider Name (Legal Business Name): MATTHEW PAUL KRAMER LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2023
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12851 GRAND RIVER RD
BRIGHTON MI
48116-8506
US

IV. Provider business mailing address

5092 FARRELL RD
DEXTER MI
48130-8619
US

V. Phone/Fax

Practice location:
  • Phone: 810-227-1211
  • Fax:
Mailing address:
  • Phone: 248-705-6786
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401225353
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: