Provider Demographics
NPI:1922403484
Name:ANNE CRAIG LLC
Entity Type:Organization
Organization Name:ANNE CRAIG LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / MGR
Authorized Official - Prefix:
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAIG
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:321-633-9333
Mailing Address - Street 1:1019 HARVIN WAY
Mailing Address - Street 2:SUITE 110
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-3286
Mailing Address - Country:US
Mailing Address - Phone:321-633-9333
Mailing Address - Fax:321-633-9334
Practice Address - Street 1:1019 HARVIN WAY
Practice Address - Street 2:SUITE 110
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-3286
Practice Address - Country:US
Practice Address - Phone:321-633-9333
Practice Address - Fax:321-633-9334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-27
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW-26321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty