Provider Demographics
NPI:1437132099
Name:VOORHEES, CRAIG MICHAEL (PHD)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:MICHAEL
Last Name:VOORHEES
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10420 OLD OLIVE STREET RD
Mailing Address - Street 2:STE 204
Mailing Address - City:CREVE COEUR
Mailing Address - State:MO
Mailing Address - Zip Code:63141-5914
Mailing Address - Country:US
Mailing Address - Phone:314-872-3972
Mailing Address - Fax:314-872-3740
Practice Address - Street 1:10420 OLD OLIVE STREET RD
Practice Address - Street 2:STE 204
Practice Address - City:CREVE COEUR
Practice Address - State:MO
Practice Address - Zip Code:63141-5914
Practice Address - Country:US
Practice Address - Phone:314-872-3972
Practice Address - Fax:314-872-3740
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-28
Last Update Date:2007-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOPY01244103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist