Individual
MR. KENNETH WAYNE MCCRAE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW,CASAC
Contact information
Practice address
415 STRATFORD RD APT 7M, BROOKLYN, NY 11218-5374
(718) 940-1145
Mailing address
937 FULTON ST, BROOKLYN, NY 11238-2347
(718) 789-2010
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
073069-1
NY
Other
Enumeration date
03/09/2009
Last updated
03/09/2009
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