Johnathan Kraus, PH.D.

Individual provider Active NPI Mental Health Counselor · Garwood, NJ

NPI 1508692153 · NPPES record last updated Sep 10, 2024

Key facts

NPI
1508692153
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
662 Willow Ave # 2
Garwood, NJ 07027-1230
Phone
(323) 974-3537
NPI assigned
Sep 10, 2024
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Philosophy

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor
Group: 193400000X SINGLE SPECIALTY GROUP
101YM0800X Yes

Addresses

Primary practice location

662 Willow Ave # 2
Garwood, NJ 07027-1230

Mailing address

662 Willow Ave # 2
Garwood, NJ 07027-1230
Phone (323) 974-3537

Other providers in Garwood, NJ

All providers in Garwood, NJ · Mental Health Counselor in New Jersey

Sources for this page

Verify at the official NPI Registry.