Provider Demographics
NPI:1144458613
Name:CRAYMER, KATHY (LLPC)
Entity type:Individual
Prefix:
First Name:KATHY
Middle Name:
Last Name:CRAYMER
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 W COLBY ST
Mailing Address - Street 2:
Mailing Address - City:WHITEHALL
Mailing Address - State:MI
Mailing Address - Zip Code:49461-1083
Mailing Address - Country:US
Mailing Address - Phone:231-893-8336
Mailing Address - Fax:231-893-8336
Practice Address - Street 1:116 W COLBY ST
Practice Address - Street 2:
Practice Address - City:WHITEHALL
Practice Address - State:MI
Practice Address - Zip Code:49461-1083
Practice Address - Country:US
Practice Address - Phone:231-893-8336
Practice Address - Fax:231-893-8336
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-23
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401011404101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health