Provider Demographics
NPI:1902916794
Name:CRAMER, MARIA ANN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:ANN
Last Name:CRAMER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:MARIA
Other - Middle Name:ANN
Other - Last Name:MARSZALEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:110 E ROUTT AVE
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81004-2117
Mailing Address - Country:US
Mailing Address - Phone:719-543-8711
Mailing Address - Fax:719-585-3048
Practice Address - Street 1:1302 E 5TH ST
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81001-3754
Practice Address - Country:US
Practice Address - Phone:719-543-8711
Practice Address - Fax:719-585-3048
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1979C1041C0700X
PACW0148441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
1455524Medicare UPIN