Provider Demographics
NPI:1548953664
Name:KRAMER, RICHELLE H (LICSW)
Entity type:Individual
Prefix:
First Name:RICHELLE
Middle Name:H
Last Name:KRAMER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 3RD AVE SW
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:MN
Mailing Address - Zip Code:55313-2266
Mailing Address - Country:US
Mailing Address - Phone:612-269-9052
Mailing Address - Fax:
Practice Address - Street 1:1801 3RD AVE SW
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:MN
Practice Address - Zip Code:55313-2266
Practice Address - Country:US
Practice Address - Phone:612-269-9052
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-02
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN208561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty