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NPI Code Detail

MEDICARE: MS. MARYLS CRAUN LCSW

MEDICARE: MS. MARYLS CRAUN LCSW
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
11041C0700XClinical Social Worker0904001374VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1394234OTHERVAANTHEM
2082535OTHERVASENTARA

General Provider Information

NPI Number : 1831116680
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARYLS CRAUN LCSW
Provider Business Mailing Address
First Line : 85 SANGERS LN
Second Line :
City : STAUNTON
State : VA
Zip : 24401-6712
Country : US
Telephone Number : 540-887-3200
Fax Number :
Provider Business Practice Location Address
First Line : 85 SANGERS LN
Second Line :
City : STAUNTON
State : VA
Zip : 24401-6712
Country : US
Telephone Number : 540-887-3200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2006
Last Update Date : 07/08/2007

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