Healthcare Provider Details

I. General information

NPI: 1578125704
Provider Name (Legal Business Name): ELIZABETH KRAUTKRAMER MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2019
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 54
SOBIESKI WI
54171
US

IV. Provider business mailing address

PO BOX 54
SOBIESKI WI
54171
US

V. Phone/Fax

Practice location:
  • Phone: 920-393-7940
  • Fax:
Mailing address:
  • Phone: 920-393-7940
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number131543-121
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number9796-123
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: