Healthcare Provider Details

I. General information

NPI: 1639111941
Provider Name (Legal Business Name): CRAIG PSYCHOLOGICAL ASSOCIATES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 03/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3226 STATE ROUTE 257
SENECA PA
16346-2434
US

IV. Provider business mailing address

3226 STATE ROUTE 257 PO BOX 449
SENECA PA
16346-2434
US

V. Phone/Fax

Practice location:
  • Phone: 814-676-2804
  • Fax: 814-676-0715
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC01710
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS 004505L
License Number StatePA

VIII. Authorized Official

Name: DR. ROBERT P. CRAIG
Title or Position: PRESIDENT
Credential: PHD
Phone: 814-676-2804