Healthcare Provider Details

I. General information

NPI: 1083268098
Provider Name (Legal Business Name): KELLEY LEE KRAMER LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2019
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2011 BURNIE BISHOP PL
CEDAR PARK TX
78613-4070
US

IV. Provider business mailing address

2011 BURNIE BISHOP PL
CEDAR PARK TX
78613-4070
US

V. Phone/Fax

Practice location:
  • Phone: 443-282-8883
  • Fax:
Mailing address:
  • Phone: 443-282-8883
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6401223932
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number99723
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE.2102357
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: