Provider Demographics
NPI:1508639824
Name:CRAYPO, MATTHEW LAWRENCE (COUNSELOR)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:LAWRENCE
Last Name:CRAYPO
Suffix:
Gender:M
Credentials:COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 T ST SW APT B18
Mailing Address - Street 2:
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98501-4579
Mailing Address - Country:US
Mailing Address - Phone:253-766-9658
Mailing Address - Fax:
Practice Address - Street 1:20311 OLD HIGHWAY 9 SW
Practice Address - Street 2:
Practice Address - City:CENTRALIA
Practice Address - State:WA
Practice Address - Zip Code:98531-9620
Practice Address - Country:US
Practice Address - Phone:360-664-4641
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-31
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty