Healthcare Provider Details

I. General information

NPI: 1417005166
Provider Name (Legal Business Name): GREGORY A KRAUSZ MA, CAADC, LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 04/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

826 DELAWARE AVE FLOOR 1
FOUNTAIN HILL PA
18015-1174
US

IV. Provider business mailing address

826 DELAWARE AVE FLOOR 1
FOUNTAIN HILL PA
18015-1174
US

V. Phone/Fax

Practice location:
  • Phone: 610-317-0503
  • Fax: 610-419-3309
Mailing address:
  • Phone: 610-317-0503
  • Fax: 610-419-3309

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberPC002319
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberPC002319
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPC002319
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License NumberPC002319
License Number StatePA
# 5
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC002319
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: