Provider Demographics
NPI:1639111941
Name:CRAIG PSYCHOLOGICAL ASSOCIATES, INC
Entity Type:Organization
Organization Name:CRAIG PSYCHOLOGICAL ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:P
Authorized Official - Last Name:CRAIG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:814-676-2804
Mailing Address - Street 1:3226 STATE ROUTE 257
Mailing Address - Street 2:PO BOX 449
Mailing Address - City:SENECA
Mailing Address - State:PA
Mailing Address - Zip Code:16346-2434
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3226 STATE ROUTE 257
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:PA
Practice Address - Zip Code:16346-2434
Practice Address - Country:US
Practice Address - Phone:814-676-2804
Practice Address - Fax:814-676-0715
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-12
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 103TB0200X
PAPC01710101YP2500X
PAPS 004505L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0050622OtherDR. C. VALUE OPTIONS NUMB
PA275136OtherBS GROUP
PA0014533790005Medicaid
PA021824OtherMEDICARE GROUP NUMBER
PA531954OtherDR. C BS NUMBER
PA021824Medicare PIN
PA0014533790005Medicaid