Provider Demographics
NPI:1992854541
Name:KURTZ, CRAIG PHILLIP (LMHC, CAP)
Entity Type:Individual
Prefix:MR
First Name:CRAIG
Middle Name:PHILLIP
Last Name:KURTZ
Suffix:
Gender:M
Credentials:LMHC, CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:877 FLEMING ST
Mailing Address - Street 2:
Mailing Address - City:GREEN COVE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32043-9342
Mailing Address - Country:US
Mailing Address - Phone:904-215-5282
Mailing Address - Fax:904-284-1624
Practice Address - Street 1:1542 KINGSLEY AVE
Practice Address - Street 2:#145
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-4586
Practice Address - Country:US
Practice Address - Phone:904-215-5282
Practice Address - Fax:904-284-1624
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5063101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health