Basic Information
| Provider Information | |||||||||
| NPI: | 1710572938 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JENNIFER L KRAMER PLLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | CONNECT COUNSELING PLLC | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6495 E 132ND ST S | ||||||||
| Address2: | |||||||||
| City: | LYNNVILLE | ||||||||
| State: | IA | ||||||||
| PostalCode: | 501538619 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6412000650 | ||||||||
| FaxNumber: | 8556831895 | ||||||||
| Practice Location | |||||||||
| Address1: | 300 E 17TH ST S STE 300 | ||||||||
| Address2: | |||||||||
| City: | NEWTON | ||||||||
| State: | IA | ||||||||
| PostalCode: | 502084059 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6412000650 | ||||||||
| FaxNumber: | 8556831895 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/09/2021 | ||||||||
| LastUpdateDate: | 03/11/2021 | ||||||||
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| AuthorizedOfficialLastName: | KRAMER | ||||||||
| AuthorizedOfficialFirstName: | JENNIFER | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 6412000650 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | LISW | ||||||||
| NPICertificationDate: | 03/11/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker | Clinical |
ID Information
| ID | Type | State | Issuer | Description | 1427431725 | 01 | IA | NPPES | OTHER |