Provider Demographics
NPI:1902822612
Name:CRAIGE, HEATHER BARKLEY (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:BARKLEY
Last Name:CRAIGE
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3404 CHURCHILL RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-6810
Mailing Address - Country:US
Mailing Address - Phone:919-787-0383
Mailing Address - Fax:919-787-0432
Practice Address - Street 1:3404 CHURCHILL RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-6810
Practice Address - Country:US
Practice Address - Phone:919-787-0383
Practice Address - Fax:919-787-0432
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCSW 0000031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC25100OtherBC/BS PROVIDER NUMBER
NCLCSW 000003OtherSTATE LICENSE