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General NPI Number Information
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NPI Number | 1811223100
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Entity Type | Individual
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Provider Name | JOHN KRACHENFELS PHD, LCSW-R, CASAC
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Gender | Male
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Dates
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Enumeration Date | 10/21/2009
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Last Update Date | 10/16/2023
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Provider Practice Location Address
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Address Line | 445 PARK AVE
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City | NEW YORK
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State | NY
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Zip | 10022-2606
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Country | US
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Telephone | 212-220-9300
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Fax |
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Provider Business Mailing Address
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Address Line | 112 NELSON AVE
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City | HARRISON
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State | NY
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Zip | 10528-2933
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Country | US
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Telephone | 516-567-4294
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 5883
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 13451
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 043858
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License Number State | NY
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