Provider Demographics
NPI:1093937641
Name:ABRAHAMSON, CRAIG EILERT (LCSW-C)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:EILERT
Last Name:ABRAHAMSON
Suffix:
Gender:M
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:POST OFFICE BOX 74
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21550-0074
Mailing Address - Country:US
Mailing Address - Phone:301-334-9202
Mailing Address - Fax:
Practice Address - Street 1:619 NEST LICK ACRES ROAD
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:MD
Practice Address - Zip Code:21550-4134
Practice Address - Country:US
Practice Address - Phone:301-334-9202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLCSW-C 60121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD794201000Medicaid
MD189519200Medicaid
MD189519200Medicaid