Provider Demographics
NPI:1942278346
Name:CRAIG, PATRICIA MALONE (LCSWR)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:MALONE
Last Name:CRAIG
Suffix:
Gender:F
Credentials:LCSWR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2128 ELMWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14207-1910
Mailing Address - Country:US
Mailing Address - Phone:716-874-4500
Mailing Address - Fax:716-874-8145
Practice Address - Street 1:2128 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14207-1910
Practice Address - Country:US
Practice Address - Phone:716-874-4500
Practice Address - Fax:716-874-8145
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR04501711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
00011249905OtherUNIVERA HEALTHCARE TRAD
000527570001OtherCB LABOR HEALTH
000527570001OtherBCBS WNY
000527570001OtherCHILD HLTH PLUS FAM HLTH
040603000013OtherFIDELIS CHILD HEALTH PLUS
000527570001OtherCOMMUNITY BLUE
000527570001OtherHEALTHY NY
000527570001OtherHMO 100
040603000013OtherFIDELIS
00011249905OtherUNIVERA COMMERCIAL
000527570001OtherCB ADVANTAGE
000527570001OtherSENIOR BLUE
000527570001OtherTRADITIONAL
040603000013OtherFIDELIS FAMILY HEALTH PLU
00011249905OtherASO
000527570001OtherCOMMUNITY CARE
00011249905OtherSENIOR CHOICE
000527570001OtherCHILD HLTH PLUS FAM HLTH
040603000013OtherFIDELIS FAMILY HEALTH PLU