Provider Demographics
NPI:1629124656
Name:CRAIG, MARI G
Entity Type:Individual
Prefix:
First Name:MARI
Middle Name:G
Last Name:CRAIG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4064 NORBECK SQ DR
Mailing Address - Street 2:MARI G CRAIG LCSW C
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20853
Mailing Address - Country:US
Mailing Address - Phone:301-929-9767
Mailing Address - Fax:301-929-9767
Practice Address - Street 1:4064 NORBECK SQ DR
Practice Address - Street 2:MARI G CRAIG LCSW C
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20853
Practice Address - Country:US
Practice Address - Phone:301-929-9767
Practice Address - Fax:301-929-9767
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD090721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
869481Medicare ID - Type Unspecified