Individual provider Active NPI

Karen Witson Kraham, LICSW, LADC

  • Mental Health Counselor
  • Brattleboro, VT
National Provider Identifier
1851423115
Registry record updated Jul 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
089-0000830 Issued in VT
Practice address
38 Park PL
Brattleboro, VT 05301-2827
Phone
(802) 257-6930
Fax
(802) 257-0051
NPI assigned
Mar 12, 2007
Last updated
Jul 7, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 089-0000830 VT Primary

Addresses

Primary practice location

38 Park PL
Brattleboro, VT 05301-2827

Mailing address

PO Box 501
Brattleboro, VT 05302-0501
Phone (802) 257-6930

Other identifiers 2

IdentifierTypeStateIssuer
1008023MedicaidVT
0005050MedicaidVT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110927000730 VT Practitioner - Clinical Social Worker 1759411176 Practice locations: Brattleboro, VT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

38 Park Place
Brattleboro, VT 05301-2827
Phone (802) 257-6930

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
089-0000830VTMDMental Health Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309996800000",
    "number": "1851423115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 501",
            "city": "BRATTLEBORO",
            "state": "VT",
            "postal_code": "053020501",
            "telephone_number": "802-257-6930",
            "fax_number": "802-257-0051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 PARK PL",
            "city": "BRATTLEBORO",
            "state": "VT",
            "postal_code": "053012827",
            "telephone_number": "802-257-6930",
            "fax_number": "802-257-0051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAHAM",
        "first_name": "KAREN",
        "middle_name": "WITSON",
        "name_prefix": "Ms.",
        "credential": "LICSW, LADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-12",
        "last_updated": "2011-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VT",
            "license": "089-0000830",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1008023",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0005050",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brattleboro, VT

Sources for this page

Verify at the official NPI Registry.