Provider Demographics
NPI:1477019313
Name:GILKEY, CRAIG JACK (LMHC)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:JACK
Last Name:GILKEY
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 W 7TH ST
Mailing Address - Street 2:
Mailing Address - City:OSWEGO
Mailing Address - State:NY
Mailing Address - Zip Code:13126-2537
Mailing Address - Country:US
Mailing Address - Phone:315-382-3041
Mailing Address - Fax:
Practice Address - Street 1:193 W 1ST ST STE 13
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:NY
Practice Address - Zip Code:13126-2576
Practice Address - Country:US
Practice Address - Phone:315-382-3041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-15
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009197101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health