Provider Demographics
NPI:1144476482
Name:KRAUSS, PAUL
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:KRAUSS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:781 KENMOOR AVE SE STE C
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-8624
Mailing Address - Country:US
Mailing Address - Phone:616-200-4433
Mailing Address - Fax:
Practice Address - Street 1:781 KENMOOR AVE SE STE C
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-8624
Practice Address - Country:US
Practice Address - Phone:616-200-4433
Practice Address - Fax:616-828-1936
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-18
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health