Provider Demographics
NPI:1538310420
Name:NORTHROP, CRAIG ANDREW (LMSW)
Entity Type:Individual
Prefix:MR
First Name:CRAIG
Middle Name:ANDREW
Last Name:NORTHROP
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 DOANSBURG RD
Mailing Address - Street 2:
Mailing Address - City:BREWSTER
Mailing Address - State:NY
Mailing Address - Zip Code:10509-5902
Mailing Address - Country:US
Mailing Address - Phone:845-279-2995
Mailing Address - Fax:
Practice Address - Street 1:400 DOANSBURG RD
Practice Address - Street 2:
Practice Address - City:BREWSTER
Practice Address - State:NY
Practice Address - Zip Code:10509-5902
Practice Address - Country:US
Practice Address - Phone:845-279-2995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-09
Last Update Date:2018-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY083401-11041C0700X
NY086931-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004040655Medicaid