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General NPI Number Information
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NPI Number | 1205473089
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Entity Type | Individual
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Provider Name | AMATULLAH CRAFT LCSW
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Gender | Female
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Dates
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Enumeration Date | 11/29/2019
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Last Update Date | 02/07/2025
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Provider Practice Location Address
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Address Line | PO BOX 310698
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City | TAMPA
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State | FL
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Zip | 33680-0698
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Country | US
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Telephone | 813-474-6751
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Fax |
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Provider Business Mailing Address
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Address Line | 10905 OBSERVATORY WAY
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City | TAMPA
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State | FL
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Zip | 33647-3583
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Country | US
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Telephone | 813-474-6752
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW20524
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License Number State | FL
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