Provider Demographics
NPI:1639403132
Name:HALES, CRAIG MARSHALL (MSW, DCSW)
Entity Type:Individual
Prefix:MR
First Name:CRAIG
Middle Name:MARSHALL
Last Name:HALES
Suffix:
Gender:M
Credentials:MSW, DCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:84 MILES RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29223-3219
Mailing Address - Country:US
Mailing Address - Phone:910-330-9204
Mailing Address - Fax:
Practice Address - Street 1:9005 TWO NOTCH RD STE 23
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29223-5851
Practice Address - Country:US
Practice Address - Phone:910-330-9204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010911061041C0700X
FLSW130091041C0700X
SC121621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical