Provider Demographics
NPI:1346799491
Name:CRAIG, DENNIS (MS)
Entity Type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:
Last Name:CRAIG
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:803 N MONROE ST
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47404-3321
Mailing Address - Country:US
Mailing Address - Phone:812-332-1262
Mailing Address - Fax:812-334-8464
Practice Address - Street 1:803 N MONROE ST
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47404-3321
Practice Address - Country:US
Practice Address - Phone:812-332-1262
Practice Address - Fax:812-334-8464
Is Sole Proprietor?:No
Enumeration Date:2016-09-30
Last Update Date:2016-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health