Basic Information
| Provider Information | |||||||||
| NPI: | 1568061125 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CRAIG | ||||||||
| FirstName: | ASHLEY | ||||||||
| MiddleName: | ALEXIS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 126 HAMPSHIRE ST | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 011511418 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4706062632 | ||||||||
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| Practice Location | |||||||||
| Address1: | 153 MAGAZINE ST | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 011094016 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8446429355 | ||||||||
| FaxNumber: | 4137320309 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/23/2020 | ||||||||
| LastUpdateDate: | 10/23/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/23/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.