Healthcare Provider Details

I. General information

NPI: 1578680781
Provider Name (Legal Business Name): MICHELE I KRAMER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 04/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

607 N JEROME AVE JEWISH FAMILY SERVICE OF ATLANTIC COUNTY
MARGATE CITY NJ
08402-1527
US

IV. Provider business mailing address

607 N JEROME AVE JEWISH FAMILY SERVICE OF ATLANTIC COUNTY
MARGATE CITY NJ
08402-1527
US

V. Phone/Fax

Practice location:
  • Phone: 609-822-1108
  • Fax: 609-822-1106
Mailing address:
  • Phone: 609-822-1108
  • Fax: 609-822-1106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW012607
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC05423600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: