Provider Demographics
NPI:1407503261
Name:CRATCHA, DANIEL STANLEY I
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:STANLEY
Last Name:CRATCHA
Suffix:I
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 NAUTICAL WAY
Mailing Address - Street 2:
Mailing Address - City:FAIRPORT HARBOR
Mailing Address - State:OH
Mailing Address - Zip Code:44077-6912
Mailing Address - Country:US
Mailing Address - Phone:216-441-0200
Mailing Address - Fax:
Practice Address - Street 1:107 NAUTICAL WAY
Practice Address - Street 2:
Practice Address - City:FAIRPORT HARBOR
Practice Address - State:OH
Practice Address - Zip Code:44077-6912
Practice Address - Country:US
Practice Address - Phone:216-441-0200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-02
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor