Provider Demographics
NPI:1508035544
Name:ASSELIN, CRAIG ALEXANDER
Entity Type:Individual
Prefix:MR
First Name:CRAIG
Middle Name:ALEXANDER
Last Name:ASSELIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 WATERTOWN RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06762-1508
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2606 CENTENNIAL PL
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-0572
Practice Address - Country:US
Practice Address - Phone:850-205-0189
Practice Address - Fax:850-329-2903
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-25
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional