Provider Demographics
NPI:1457646994
Name:FOX, CRAIG RICHARD (MACP)
Entity Type:Individual
Prefix:MR
First Name:CRAIG
Middle Name:RICHARD
Last Name:FOX
Suffix:
Gender:M
Credentials:MACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 FOX WAY
Mailing Address - Street 2:CROSSROAD COUNSELING
Mailing Address - City:PETERSBURG
Mailing Address - State:NY
Mailing Address - Zip Code:12138
Mailing Address - Country:US
Mailing Address - Phone:518-658-3131
Mailing Address - Fax:
Practice Address - Street 1:85 FOX WAY
Practice Address - Street 2:CROSSROAD COUNSELING
Practice Address - City:PETERSBURG
Practice Address - State:NY
Practice Address - Zip Code:12138
Practice Address - Country:US
Practice Address - Phone:518-658-3131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-13
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling