Provider Demographics
NPI:1104090240
Name:KRAMER, LINDSAY (LICSW, MS)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:KRAMER
Suffix:
Gender:F
Credentials:LICSW, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3401 N 191ST AVE
Mailing Address - Street 2:
Mailing Address - City:ELKHORN
Mailing Address - State:NE
Mailing Address - Zip Code:68022-3350
Mailing Address - Country:US
Mailing Address - Phone:402-699-9911
Mailing Address - Fax:402-238-1859
Practice Address - Street 1:3401 N 191ST AVE
Practice Address - Street 2:
Practice Address - City:ELKHORN
Practice Address - State:NE
Practice Address - Zip Code:68022-3350
Practice Address - Country:US
Practice Address - Phone:402-909-2787
Practice Address - Fax:402-238-1859
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-19
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150010714104100000X
IL22416541041S0200X
NE8621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025961100Medicaid
NE10025961100Medicaid