Healthcare Provider Details
I. General information
NPI: 1992221048
Provider Name (Legal Business Name): CRAIG WILLIAM HANAUER LPC, LCAT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/21/2017
Last Update Date: 06/08/2021
Certification Date: 06/08/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
235 W 22ND ST APT 6Y
NEW YORK NY
10011-2747
US
IV. Provider business mailing address
235 W 22ND ST APT 6Y
NEW YORK NY
10011-2747
US
V. Phone/Fax
- Phone: 917-881-3713
- Fax:
- Phone: 917-881-3713
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 246ZA2600X |
| Taxonomy | Medical Art Specialist/Technologist |
| License Number | 000218-1 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | PC013133 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: