Provider Demographics
NPI:1700381126
Name:CRAIG, STEWART TERRELL (MED, CAADC, LPC)
Entity Type:Individual
Prefix:MR
First Name:STEWART
Middle Name:TERRELL
Last Name:CRAIG
Suffix:
Gender:M
Credentials:MED, CAADC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:480 NEW HOLLAND AVE STE 8312
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-2292
Mailing Address - Country:US
Mailing Address - Phone:717-419-4917
Mailing Address - Fax:
Practice Address - Street 1:351 W JAMES ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-2911
Practice Address - Country:US
Practice Address - Phone:717-419-4917
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-27
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC010145101Y00000X, 101YA0400X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)