Provider Demographics
NPI:1255851796
Name:CRAFT, LINDA ANN (LCSW, LPHA)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:ANN
Last Name:CRAFT
Suffix:
Gender:F
Credentials:LCSW, LPHA
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:ANN
Other - Last Name:HIX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:611 W PARK ST
Mailing Address - Street 2:
Mailing Address - City:URBANA
Mailing Address - State:IL
Mailing Address - Zip Code:61801-2529
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:311 W FAIRCHILD ST
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:IL
Practice Address - Zip Code:61832-3876
Practice Address - Country:US
Practice Address - Phone:217-431-7600
Practice Address - Fax:217-431-7850
Is Sole Proprietor?:No
Enumeration Date:2017-06-26
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490124521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical