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NPI 1336809318

NPI 1336809318 : SAMANTHA MARIE KRAFT LPC : APPLETON, WI

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General NPI Number Information
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    NPI Number           |    1336809318
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    Entity Type          |    Individual 
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    Provider Name        |    SAMANTHA MARIE KRAFT LPC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    12/18/2021
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    Last Update Date     |    07/25/2023
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Provider Practice Location Address
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    Address Line         |    3121 W SPENCER ST 
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    City                 |    APPLETON
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    State                |    WI
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    Zip                  |    54914-4308
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    Country              |    US
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    Telephone            |    920-385-5051
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    Fax                  |    202-771-8499
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Provider Business Mailing Address
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    Address Line         |    3121 W SPENCER ST 
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    City                 |    APPLETON
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    State                |    WI
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    Zip                  |    54914-4308
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    Country              |    US
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    Telephone            |    920-385-5051
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    4898226
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    License Number State |    WI
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Taxonomy #2
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    Taxonomy Code        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    8593125
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    License Number State |    WI
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