Healthcare Provider Details

I. General information

NPI: 1932619061
Provider Name (Legal Business Name): CRAIG M WARNER LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2017
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

606 DEPOT ST
MAZON IL
60444-3703
US

IV. Provider business mailing address

150 S PRIMROSE DR
COAL CITY IL
60416-4102
US

V. Phone/Fax

Practice location:
  • Phone: 815-315-8380
  • Fax:
Mailing address:
  • Phone: 815-405-7100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number32998
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number32998
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149026725
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number32998
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: