Provider Demographics
NPI:1699486613
Name:KRANTZ, DAVID MATTHEW (LCMHC-A)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:MATTHEW
Last Name:KRANTZ
Suffix:
Gender:F
Credentials:LCMHC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:183 STONEY FORK RD
Mailing Address - Street 2:
Mailing Address - City:BARNARDSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28709-9797
Mailing Address - Country:US
Mailing Address - Phone:336-324-2548
Mailing Address - Fax:
Practice Address - Street 1:183 STONEY FORK RD
Practice Address - Street 2:
Practice Address - City:BARNARDSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28709-9797
Practice Address - Country:US
Practice Address - Phone:336-324-2548
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-09
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA17812101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health