Provider Demographics
NPI:1023247012
Name:DIKE, CRAIG ANDREW (PSYD)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:ANDREW
Last Name:DIKE
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7400 MERTON MINTER ST
Mailing Address - Street 2:116B PSYCHOLOGY SERVICE
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4404
Mailing Address - Country:US
Mailing Address - Phone:210-617-5121
Mailing Address - Fax:
Practice Address - Street 1:3700 CRESTWOOD PKWY NW STE 500
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-5585
Practice Address - Country:US
Practice Address - Phone:678-924-5756
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-10
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001175103TC0700X
TX38905103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical