Provider Demographics
NPI:1245670892
Name:KRAUSS, SUSAN (LMSW)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:KRAUSS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9
Mailing Address - Street 2:
Mailing Address - City:LAKE HILL
Mailing Address - State:NY
Mailing Address - Zip Code:12448-0009
Mailing Address - Country:US
Mailing Address - Phone:845-679-5290
Mailing Address - Fax:
Practice Address - Street 1:21 S CHESTNUT ST
Practice Address - Street 2:SUITE 104
Practice Address - City:NEW PALTZ
Practice Address - State:NY
Practice Address - Zip Code:12561-1943
Practice Address - Country:US
Practice Address - Phone:845-679-5290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-27
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 101YA0400X, 101YM0800X, 106H00000X
NY005169104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist