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General NPI Number Information
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NPI Number | 1275279127
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Entity Type | Organization
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Legal Business Name | MICHAEL J. CRAYTOR, LPC
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Dates
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Enumeration Date | 05/12/2022
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Last Update Date | 05/12/2022
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Provider Practice Location Address
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Address Line | 234 4TH AVE
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City | SEWARD
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State | AK
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Zip | 99664-9966
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Country | US
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Telephone | 907-422-0606
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 803
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City | SEWARD
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State | AK
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Zip | 99664-0803
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Country | US
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Telephone | 907-422-0606
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MICHAEL JOSEPH CRAYTOR
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Credential | LPC
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Telephone | 907-422-0606
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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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 | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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