Provider Demographics
NPI:1669516902
Name:CRAVEY, KEN (MSW, LCSW)
Entity type:Individual
Prefix:MR
First Name:KEN
Middle Name:
Last Name:CRAVEY
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 LAVANHAM CT
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32712-3069
Mailing Address - Country:US
Mailing Address - Phone:407-592-3897
Mailing Address - Fax:866-858-0962
Practice Address - Street 1:1201 LAVANHAM CT
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32712-3069
Practice Address - Country:US
Practice Address - Phone:407-592-3897
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW84091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical