Provider Demographics
NPI:1467560623
Name:RASMUSSEN, CRAIG J (MA, LCSW)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:J
Last Name:RASMUSSEN
Suffix:
Gender:M
Credentials:MA, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3930 8TH ST S
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WISCONSIN RAPIDS
Mailing Address - State:WI
Mailing Address - Zip Code:54494-6511
Mailing Address - Country:US
Mailing Address - Phone:715-423-2030
Mailing Address - Fax:715-423-2032
Practice Address - Street 1:3930 8TH ST S
Practice Address - Street 2:SUITE 101
Practice Address - City:WISCONSIN RAPIDS
Practice Address - State:WI
Practice Address - Zip Code:54494-6511
Practice Address - Country:US
Practice Address - Phone:715-423-2030
Practice Address - Fax:715-423-2032
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2283-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical