Provider Demographics
NPI:1245217892
Name:MANKIN, CRAIG WILLIAM (PCC)
Entity Type:Individual
Prefix:MR
First Name:CRAIG
Middle Name:WILLIAM
Last Name:MANKIN
Suffix:
Gender:M
Credentials:PCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5134 CEDAR VILLAGE DR
Mailing Address - Street 2:3C
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-3717
Mailing Address - Country:US
Mailing Address - Phone:513-229-7900
Mailing Address - Fax:513-229-0202
Practice Address - Street 1:5134 CEDAR VILLAGE DR
Practice Address - Street 2:3C
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-3717
Practice Address - Country:US
Practice Address - Phone:513-229-7900
Practice Address - Fax:513-229-0202
Is Sole Proprietor?:No
Enumeration Date:2005-12-26
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0003811101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health