Provider Demographics
NPI:1063741791
Name:KRAYER, SUSAN B (LPC)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:B
Last Name:KRAYER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7593
Mailing Address - Street 2:
Mailing Address - City:BROOKINGS
Mailing Address - State:OR
Mailing Address - Zip Code:97415-0347
Mailing Address - Country:US
Mailing Address - Phone:541-736-3882
Mailing Address - Fax:541-736-3882
Practice Address - Street 1:97829 SHOPPING CENTER AVE
Practice Address - Street 2:
Practice Address - City:HARBOR
Practice Address - State:OR
Practice Address - Zip Code:97415-9135
Practice Address - Country:US
Practice Address - Phone:541-735-2126
Practice Address - Fax:541-736-3882
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-08
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3174101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health