Provider Demographics
NPI:1629264866
Name:CRAIG, ANNE ELIZABETH (LCSW)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:ELIZABETH
Last Name:CRAIG
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:
Other - Last Name:CRAIG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LLC
Mailing Address - Street 1:1019 HARVIN WAY
Mailing Address - Street 2:SUITE 110
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-3286
Mailing Address - Country:US
Mailing Address - Phone:321-633-9333
Mailing Address - Fax:321-633-9334
Practice Address - Street 1:1019 HARVIN WAY
Practice Address - Street 2:SUITE 110
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-3286
Practice Address - Country:US
Practice Address - Phone:321-633-9333
Practice Address - Fax:321-633-9334
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-21
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 26321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical