Provider Demographics
NPI:1871796417
Name:KRALL, CAROLINE WEINERT (EDM, LPC, NCC)
Entity type:Individual
Prefix:MRS
First Name:CAROLINE
Middle Name:WEINERT
Last Name:KRALL
Suffix:
Gender:F
Credentials:EDM, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 ASPEN WAY
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17110-9685
Mailing Address - Country:US
Mailing Address - Phone:717-540-0470
Mailing Address - Fax:
Practice Address - Street 1:5351 JAYCEE AVE # C
Practice Address - Street 2:SUITE 1
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112-2938
Practice Address - Country:US
Practice Address - Phone:717-657-2080
Practice Address - Fax:717-657-2290
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC004453101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health