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NPI Code Detail

MEDICARE: LAURA EILEEN KRAUSE LCSW-C

MEDICARE: LAURA EILEEN KRAUSE LCSW-C
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
11041C0700XClinical Social Worker17714MD

General Provider Information

NPI Number : 1528389798
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA EILEEN KRAUSE LCSW-C
Provider Business Mailing Address
First Line : 12501 PROSPERITY DR STE 310
Second Line :
City : SILVER SPRING
State : MD
Zip : 20904-1699
Country : US
Telephone Number : 240-780-8884
Fax Number :
Provider Business Practice Location Address
First Line : 12501 PROSPERITY DR STE 310
Second Line :
City : SILVER SPRING
State : MD
Zip : 20904-1699
Country : US
Telephone Number : 240-780-8884
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2010
Last Update Date : 07/21/2022

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