Provider Demographics
NPI:1437498003
Name:CHILCOTT, CRAIG (LCPC)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:
Last Name:CHILCOTT
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6400 BALTIMORE NATIONAL PIKE STE 170A-317
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-3930
Mailing Address - Country:US
Mailing Address - Phone:410-429-0605
Mailing Address - Fax:
Practice Address - Street 1:632 FREDERICK RD # 303
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-4696
Practice Address - Country:US
Practice Address - Phone:410-429-0605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-01
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC5353101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD071009100Medicaid
MD359010100Medicaid