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General NPI Number Information
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NPI Number | 1891945705
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Entity Type | Organization
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Legal Business Name | CRAIG PROFESSIONAL SERVICES
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Dates
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Enumeration Date | 09/27/2008
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Last Update Date | 10/09/2008
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Provider Practice Location Address
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Address Line | 3300 PINE AVE
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City | WACO
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State | TX
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Zip | 76708-3142
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Country | US
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Telephone | 254-855-5103
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Fax |
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Provider Business Mailing Address
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Address Line | 3300 PINE AVE
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City | WACO
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State | TX
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Zip | 76708-3142
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | MR. JASON CRAIG
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Credential | LPC
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Telephone | 254-855-5103
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 32607
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 51927
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 17012
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License Number State | TX
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