MEDICARE: MRS. SARAH ELIZABETH CRAYCRAFT M.S., LPCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	LPCC.0014210	CO

General Provider Information

NPI Number	:	1184159683
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SARAH ELIZABETH CRAYCRAFT M.S., LPCC

Provider Business Mailing Address
First Line	:	204 WALNUT ST
Second Line	:	SUITE G
City	:	FORT COLLINS
State	:	CO
Zip	:	80524-2485
Country	:	US
Telephone Number	:	970-829-1888
Fax Number	:

Provider Business Practice Location Address
First Line	:	204 WALNUT ST
Second Line	:	SUITE G
City	:	FORT COLLINS
State	:	CO
Zip	:	80524-2485
Country	:	US
Telephone Number	:	970-829-1888
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/22/2017
Last Update Date	:	04/22/2017

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