Healthcare Provider Details

I. General information

NPI: 1255484531
Provider Name (Legal Business Name): LAURA MCKAY KRATZ M. ED., LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 WESCOTT DR HBH
FLEMINGTON NJ
08822-4603
US

IV. Provider business mailing address

2100 WESCOTT DR HBH 5TH FL ATTN LILY
FLEMINGTON NJ
08822-4603
US

V. Phone/Fax

Practice location:
  • Phone: 908-788-6401
  • Fax: 908-788-6110
Mailing address:
  • Phone: 908-788-6401
  • Fax: 908-788-6110

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37PC00115300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: