Provider Demographics
NPI:1285332551
Name:KRAMER, KIMBERLY (LPC-IT)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:KRAMER
Suffix:
Gender:F
Credentials:LPC-IT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2233 N SUMMIT AVE APT 215
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-1239
Mailing Address - Country:US
Mailing Address - Phone:262-825-3000
Mailing Address - Fax:
Practice Address - Street 1:5250 E TERRACE DR STE 114
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53718-8345
Practice Address - Country:US
Practice Address - Phone:608-405-5111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-16
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7212-226101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor