Provider Demographics
NPI:1205473089
Name:CRAFT, AMATULLAH (LCSW)
Entity type:Individual
Prefix:
First Name:AMATULLAH
Middle Name:
Last Name:CRAFT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:AMATULLAH
Other - Middle Name:
Other - Last Name:ALI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10905 OBSERVATORY WAY
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-3583
Mailing Address - Country:US
Mailing Address - Phone:813-474-6752
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 310698
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33680-0698
Practice Address - Country:US
Practice Address - Phone:813-474-6751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-29
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 171W00000X
FLSW205241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No171W00000XOther Service ProvidersContractor