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General NPI Number Information
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NPI Number | 1144015835
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Entity Type | Organization
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Legal Business Name | BRUCE CRAIG, LPC
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Dates
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Enumeration Date | 04/12/2025
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 10712 BALLANTRAYE DR STE 310
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City | FREDERICKSBURG
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State | VA
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Zip | 22407-4702
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Country | US
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Telephone | 540-542-6913
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Fax |
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Provider Business Mailing Address
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Address Line | 1918 WHITE LAKE DR
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City | FREDERICKSBURG
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State | VA
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Zip | 22407-1482
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Country | US
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Telephone | 760-409-1929
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. BRUCE ANTHONY CRAIG JR.
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Credential | MA
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Telephone | 540-542-6913
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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