Individual
MR. LOUIS RAY CRADDOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS
Contact information
Practice address
800 SENECA DR, BELPRE, OH 45714-1141
(740) 423-4707
(740) 423-6976
Mailing address
800 SENECA DR, BELPRE, OH 45714-1141
(740) 423-4707
(740) 423-6976
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
670
WV
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
670
WV
103TC0700X
Clinical Psychologist
670
WV
103TF0200X
Forensic Psychologist
670
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0164801000
—
WV
Enumeration date
09/21/2006
Last updated
09/11/2025
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