Provider Demographics
NPI:1003586710
Name:MCCRACKEN, WILLIAM B (LCSW,ICADC)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:B
Last Name:MCCRACKEN
Suffix:
Gender:M
Credentials:LCSW,ICADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 FINGERBOARD SCHOOLHOUS RD
Mailing Address - Street 2:
Mailing Address - City:EARLEVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21919-1420
Mailing Address - Country:US
Mailing Address - Phone:443-347-4485
Mailing Address - Fax:
Practice Address - Street 1:2607 N HARRISON ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19802-2922
Practice Address - Country:US
Practice Address - Phone:302-307-1779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-14
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD127351041C0700X
DEQ1-00005641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical