MEDICARE: MR. CRAIG ALAN HANDWERKER LMHC

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	MH6657	FL

General Provider Information

NPI Number	:	1861690851
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CRAIG ALAN HANDWERKER LMHC

Provider Business Mailing Address
First Line	:	1255 SW 46TH AVE
Second Line	:	#1712
City	:	POMPANO BEACH
State	:	FL
Zip	:	33069
Country	:	US
Telephone Number	:	954-464-3138
Fax Number	:

Provider Business Practice Location Address
First Line	:	4200 SW 54TH CT
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33314
Country	:	US
Telephone Number	:	954-880-9037
Fax Number	:	954-880-9037

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

Provider Enumeration Date	:	07/11/2007
Last Update Date	:	07/11/2007

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