Provider Demographics
NPI:1659519445
Name:CRAIG, GINGER ROBYN (LMSW, LCSW)
Entity Type:Individual
Prefix:
First Name:GINGER
Middle Name:ROBYN
Last Name:CRAIG
Suffix:
Gender:F
Credentials:LMSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1036 VICTORY BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10301
Mailing Address - Country:US
Mailing Address - Phone:718-727-3313
Mailing Address - Fax:718-727-3317
Practice Address - Street 1:1036 VICTORY BLVD.
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10301
Practice Address - Country:US
Practice Address - Phone:718-727-3313
Practice Address - Fax:718-727-3317
Is Sole Proprietor?:No
Enumeration Date:2009-02-02
Last Update Date:2014-06-06
Deactivation Date:2012-02-06
Deactivation Code:
Reactivation Date:2014-02-26
Provider Licenses
StateLicense IDTaxonomies
NY0622341041C0700X
NY0814361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical