Provider Demographics
NPI:1396865481
Name:CRABTREE, CRAIG RANDALL (LMSW, PHD)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:RANDALL
Last Name:CRABTREE
Suffix:
Gender:M
Credentials:LMSW, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 RIVER RD
Mailing Address - Street 2:#6K
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10044-1151
Mailing Address - Country:US
Mailing Address - Phone:718-260-4831
Mailing Address - Fax:
Practice Address - Street 1:CUMBERLAND CTC
Practice Address - Street 2:100 N. PORTLAND AVE.
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11205
Practice Address - Country:US
Practice Address - Phone:718-260-4831
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0653991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical