Provider Demographics
NPI:1083730998
Name:CRAIGE, KATHRYN A
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:A
Last Name:CRAIGE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 249
Mailing Address - Street 2:
Mailing Address - City:SNOW HILL
Mailing Address - State:MD
Mailing Address - Zip Code:21863-0249
Mailing Address - Country:US
Mailing Address - Phone:410-632-1100
Mailing Address - Fax:
Practice Address - Street 1:6040 PUBLIC LANDING RD
Practice Address - Street 2:
Practice Address - City:SNOW HILL
Practice Address - State:MD
Practice Address - Zip Code:21863-2453
Practice Address - Country:US
Practice Address - Phone:410-632-1100
Practice Address - Fax:410-632-0906
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD705371101Medicaid
MD705371101Medicaid