Provider Demographics
NPI:1114007952
Name:KRAUSS, PEGGY JEAN (LCADC)
Entity type:Individual
Prefix:MRS
First Name:PEGGY
Middle Name:JEAN
Last Name:KRAUSS
Suffix:
Gender:F
Credentials:LCADC
Other - Prefix:
Other - First Name:PEGGY
Other - Middle Name:JEAN
Other - Last Name:LAHMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:HD-MEDDAC
Mailing Address - Street 2:CMR 442 ATTN: CREDENTIALS OFFICE
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09042
Mailing Address - Country:DE
Mailing Address - Phone:49622-117-2274
Mailing Address - Fax:49622-117-2941
Practice Address - Street 1:HD-MEDDAC
Practice Address - Street 2:CMR 442 ATTN: CREDENTIALS OFFICE
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09042
Practice Address - Country:DE
Practice Address - Phone:49622-117-2274
Practice Address - Fax:49622-117-2941
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLCA078101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)