Healthcare Provider Details

I. General information

NPI: 1508035544
Provider Name (Legal Business Name): CRAIG ALEXANDER ASSELIN PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/25/2008
Last Update Date: 08/20/2025
Certification Date: 08/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2606 CENTENNIAL PL
TALLAHASSEE FL
32308-0572
US

IV. Provider business mailing address

2606 CENTENNIAL PL
TALLAHASSEE FL
32308-0572
US

V. Phone/Fax

Practice location:
  • Phone: 850-205-0189
  • Fax: 850-329-2903
Mailing address:
  • Phone: 850-205-0189
  • Fax: 850-329-2903

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number024838
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY8952
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: