Provider Demographics
NPI:1164869202
Name:CASHWELL, CRAIG SCOTT (PHD)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:SCOTT
Last Name:CASHWELL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:743 ASHVIEW DR
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-3422
Mailing Address - Country:US
Mailing Address - Phone:336-655-8563
Mailing Address - Fax:
Practice Address - Street 1:1000 SPRING GARDEN STREET
Practice Address - Street 2:SCHOOL OF EDUCATION
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27402
Practice Address - Country:US
Practice Address - Phone:336-334-3427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-30
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4686101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional