Provider Demographics
NPI:1811011737
Name:BLANCHARD, CRAIG S (MFT)
Entity type:Individual
Prefix:
First Name:CRAIG
Middle Name:S
Last Name:BLANCHARD
Suffix:
Gender:
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3703 LONG BEACH BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-3332
Mailing Address - Country:US
Mailing Address - Phone:562-427-3897
Mailing Address - Fax:562-309-9998
Practice Address - Street 1:3703 LONG BEACH BLVD STE 400
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-3332
Practice Address - Country:US
Practice Address - Phone:562-427-3897
Practice Address - Fax:562-309-9998
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-17
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC33333106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist