Provider Demographics
NPI:1386700441
Name:KRAMER, LORETTA ROSE (MC,LPC,LISAC)
Entity type:Individual
Prefix:MRS
First Name:LORETTA
Middle Name:ROSE
Last Name:KRAMER
Suffix:
Gender:F
Credentials:MC,LPC,LISAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10455 N GILA RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85742-9651
Mailing Address - Country:US
Mailing Address - Phone:520-744-3131
Mailing Address - Fax:
Practice Address - Street 1:10455 N GILA RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85742
Practice Address - Country:US
Practice Address - Phone:520-744-3131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-30
Last Update Date:2018-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLISAC10114101YA0400X
AZLPC1994101Y00000X
AZAP11039363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor