Provider Demographics
NPI:1952703639
Name:CRAFT, SANJA (LCSW)
Entity Type:Individual
Prefix:
First Name:SANJA
Middle Name:
Last Name:CRAFT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:803 COUNTY ROAD 342
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-0401
Mailing Address - Country:US
Mailing Address - Phone:870-219-0302
Mailing Address - Fax:
Practice Address - Street 1:503 SE LINDSEY ST
Practice Address - Street 2:
Practice Address - City:HOXIE
Practice Address - State:AR
Practice Address - Zip Code:72433-2224
Practice Address - Country:US
Practice Address - Phone:870-886-1333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-24
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR7176-M104100000X
AR7176-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR230835719Medicaid