Provider Demographics
NPI:1285643270
Name:DUPUIS, CRAIG R (LPC, LMFT)
Entity Type:Individual
Prefix:MR
First Name:CRAIG
Middle Name:R
Last Name:DUPUIS
Suffix:
Gender:M
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8700 CENTREVILLE ROAD
Mailing Address - Street 2:SUITE 410
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110
Mailing Address - Country:US
Mailing Address - Phone:703-393-7905
Mailing Address - Fax:703-393-9227
Practice Address - Street 1:8700 CENTREVILLE ROAD
Practice Address - Street 2:SUITE 410
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110
Practice Address - Country:US
Practice Address - Phone:703-393-7905
Practice Address - Fax:703-393-9227
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701002496101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health