Basic Information
| Provider Information | |||||||||
| NPI: | 1710141841 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KRAUSKOPF | ||||||||
| FirstName: | NIOME | ||||||||
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| Credential: | MSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10580 LIGON MILL RD | ||||||||
| Address2: | SUITE 210 | ||||||||
| City: | WAKE FOREST | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275876090 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9192639592 | ||||||||
| FaxNumber: | 9192639670 | ||||||||
| Practice Location | |||||||||
| Address1: | 10580 LIGON MILL RD | ||||||||
| Address2: | SUITE 210 | ||||||||
| City: | WAKE FOREST | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275876090 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9192639592 | ||||||||
| FaxNumber: | 9192639670 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/17/2008 | ||||||||
| LastUpdateDate: | 03/02/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | ISW4885 | FL | N | Behavioral Health & Social Service Providers | Social Worker | 1041C0700X | C009888 | NC | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.