Healthcare Provider Details

I. General information

NPI: 1922516509
Provider Name (Legal Business Name): CRAIG ANDREW PRESSLEY LICSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2018
Last Update Date: 01/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 FRANCIS ST STE 7
BOSTON MA
02215-5501
US

IV. Provider business mailing address

29 W WYOMING AVE APT 2
MELROSE MA
02176-4625
US

V. Phone/Fax

Practice location:
  • Phone: 617-632-9700
  • Fax: 617-632-9804
Mailing address:
  • Phone: 423-667-4894
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149.014776
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number119668
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: