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NPI Code Detail

MEDICARE: PAUL KRAUSS

MEDICARE: PAUL KRAUSS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor
2101Y00000XCounselor

General Provider Information

NPI Number : 1144476482
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAUL KRAUSS
Provider Business Mailing Address
First Line : 781 KENMOOR AVE SE STE C
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49546-8624
Country : US
Telephone Number : 616-200-4433
Fax Number :
Provider Business Practice Location Address
First Line : 781 KENMOOR AVE SE STE C
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49546-8624
Country : US
Telephone Number : 616-200-4433
Fax Number : 616-828-1936
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2008
Last Update Date : 02/17/2022

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