=====================================================
General NPI Number Information
=====================================================
NPI Number | 1801017934
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ARLENE BARBARA KRAMER LCSW,ACSW,BCD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/02/2007
-----------------------------------------------------
Last Update Date | 07/09/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 700 ARDMORE AVE #217
-----------------------------------------------------
City | ARDMORE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19003-1106
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-649-3637
-----------------------------------------------------
Fax | 610-649-7899
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 700 ARDMORE AVE #217
-----------------------------------------------------
City | ARDMORE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19003-1106
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-649-3637
-----------------------------------------------------
Fax | 610-649-7899
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | CW002418L
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------