Provider Demographics
NPI:1285176776
Name:MCDANIEL, KRAMER (LCSW)
Entity type:Individual
Prefix:
First Name:KRAMER
Middle Name:
Last Name:MCDANIEL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 RIDGEWAY DR
Mailing Address - Street 2:STE 107
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-3402
Mailing Address - Country:US
Mailing Address - Phone:337-335-0728
Mailing Address - Fax:
Practice Address - Street 1:141 RIDGEWAY DR
Practice Address - Street 2:STE 107
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-3402
Practice Address - Country:US
Practice Address - Phone:337-335-0728
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-15
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA12303104100000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA600720410Medicaid