Provider Demographics
NPI:1457666489
Name:CRAIG, JANE ANN (LMHC)
Entity Type:Individual
Prefix:MS
First Name:JANE
Middle Name:ANN
Last Name:CRAIG
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2321 W DAYTON AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:WA
Mailing Address - Zip Code:98584-6319
Mailing Address - Country:US
Mailing Address - Phone:360-426-4433
Mailing Address - Fax:360-432-1512
Practice Address - Street 1:2321 W DAYTON AIRPORT RD
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:WA
Practice Address - Zip Code:98584-6319
Practice Address - Country:US
Practice Address - Phone:360-426-4433
Practice Address - Fax:360-432-1512
Is Sole Proprietor?:No
Enumeration Date:2010-08-14
Last Update Date:2010-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60040605101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health