Provider Demographics
NPI:1912892217
Name:CARLTON, CRAIG J
Entity type:Individual
Prefix:
First Name:CRAIG
Middle Name:J
Last Name:CARLTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:191 WYNDGATE VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:LAKE SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63367-5000
Mailing Address - Country:US
Mailing Address - Phone:910-916-6776
Mailing Address - Fax:
Practice Address - Street 1:301 SOVEREIGN CT STE 115
Practice Address - Street 2:
Practice Address - City:BALLWIN
Practice Address - State:MO
Practice Address - Zip Code:63011-4435
Practice Address - Country:US
Practice Address - Phone:636-234-3052
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-09
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional