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General NPI Number Information
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NPI Number | 1679439632
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Entity Type | Individual
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Provider Name | JAMES R KRATZKE LMSW
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Gender | Male
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Dates
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Enumeration Date | 01/02/2026
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Last Update Date | 01/02/2026
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Provider Practice Location Address
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Address Line | 435 BUCKLAND RD
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City | SOUTH WINDSOR
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State | CT
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Zip | 06074-3720
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Country | US
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Telephone | 860-893-5628
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Fax |
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Provider Business Mailing Address
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Address Line | 33 SEYMOUR ST
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City | WINDSOR
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State | CT
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Zip | 06095-3445
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Country | US
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Telephone | 860-474-3140
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 9912
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License Number State | CT
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