Provider Demographics
NPI:1992232755
Name:KRAMER, CAROL ANN (LMFT)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:ANN
Last Name:KRAMER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:ANN
Other - Last Name:BLACKSTOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:8027 68TH LOOP SE
Mailing Address - Street 2:
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98513-5229
Mailing Address - Country:US
Mailing Address - Phone:360-489-1379
Mailing Address - Fax:
Practice Address - Street 1:203 4TH AVE E STE 411
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98501-1189
Practice Address - Country:US
Practice Address - Phone:360-489-1379
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-11
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF00001169106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist