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Individual

MR. DOUGLAS EDWARD CRADDOCK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMHC, LPCC

Contact information

Practice address
25400 US 19 N, SUITE 107, CLEARWATER, FL 33763-2149
(727) 791-8714
Mailing address
25400 US HIGHWAY 19 N, SUITE 107, CLEARWATER, FL 33763-2149
(727) 791-8714

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
MH10055
FL
101YP2500X
Professional Counselor
Primary
E-2588
OH

Other

Enumeration date
02/23/2009
Last updated
07/13/2011
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