Provider Demographics
NPI:1396491288
Name:CRAIG-AKINSANYA, COLLEEN (LICSW)
Entity type:Individual
Prefix:
First Name:COLLEEN
Middle Name:
Last Name:CRAIG-AKINSANYA
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1414 GOLDEN SPRINGS RD # 345
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36207-6924
Mailing Address - Country:US
Mailing Address - Phone:256-322-6886
Mailing Address - Fax:
Practice Address - Street 1:305 E BATTLE ST
Practice Address - Street 2:
Practice Address - City:TALLADEGA
Practice Address - State:AL
Practice Address - Zip Code:35160-1701
Practice Address - Country:US
Practice Address - Phone:256-223-3171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-01
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4826C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical