Provider Demographics
NPI:1326330283
Name:FRIES, CRAIG G (LPC)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:G
Last Name:FRIES
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:167 S SHORE DR
Mailing Address - Street 2:
Mailing Address - City:THOMPSON
Mailing Address - State:PA
Mailing Address - Zip Code:18465-9218
Mailing Address - Country:US
Mailing Address - Phone:570-727-2234
Mailing Address - Fax:
Practice Address - Street 1:167 S SHORE DR
Practice Address - Street 2:
Practice Address - City:THOMPSON
Practice Address - State:PA
Practice Address - Zip Code:18465-9218
Practice Address - Country:US
Practice Address - Phone:570-727-2234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-11
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC003237101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional