Provider Demographics
NPI:1043315518
Name:KRAMER, JERI LEE (PSYD, LPC)
Entity type:Individual
Prefix:DR
First Name:JERI
Middle Name:LEE
Last Name:KRAMER
Suffix:
Gender:F
Credentials:PSYD, LPC
Other - Prefix:MS
Other - First Name:JERI
Other - Middle Name:LEE
Other - Last Name:MAUK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:4249 E SAHUARO DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85028-3522
Mailing Address - Country:US
Mailing Address - Phone:602-690-7763
Mailing Address - Fax:602-680-3055
Practice Address - Street 1:4249 E SAHUARO DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028-3522
Practice Address - Country:US
Practice Address - Phone:602-690-7763
Practice Address - Fax:602-680-3055
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2015-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-11783101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ103006Medicaid