Provider Demographics
NPI:1629219860
Name:KREAMER, EZRA (LCSW)
Entity type:Individual
Prefix:
First Name:EZRA
Middle Name:
Last Name:KREAMER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 MILLER ST
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-6407
Mailing Address - Country:US
Mailing Address - Phone:207-619-4116
Mailing Address - Fax:207-618-6766
Practice Address - Street 1:129 MILLER ST
Practice Address - Street 2:
Practice Address - City:BELFAST
Practice Address - State:ME
Practice Address - Zip Code:04915-6407
Practice Address - Country:US
Practice Address - Phone:207-619-4116
Practice Address - Fax:207-618-6766
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-18
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC110821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical