Provider Demographics
NPI:1083982938
Name:CRAIG P KURTZ LMHC, PA
Entity Type:Organization
Organization Name:CRAIG P KURTZ LMHC, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:PHILLIP
Authorized Official - Last Name:KURTZ
Authorized Official - Suffix:
Authorized Official - Credentials:LHC, CAP
Authorized Official - Phone:904-215-5282
Mailing Address - Street 1:PO BOX 8057
Mailing Address - Street 2:
Mailing Address - City:FLEMING ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32006-0005
Mailing Address - Country:US
Mailing Address - Phone:904-215-5282
Mailing Address - Fax:904-284-1624
Practice Address - Street 1:877 FLEMING ST
Practice Address - Street 2:
Practice Address - City:FLEMING ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32003-9342
Practice Address - Country:US
Practice Address - Phone:904-215-5282
Practice Address - Fax:904-284-1624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-07
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5063251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health