Craddock, Geraldine Baker

Craddock, Geraldine Baker is an sole proprietor health care provider with primary practice located at 1588 Hill Rise Dr , Lexington KY 40504-2587. She recently has only one registered license in Residential Treatment Facilities / Substance Abuse Rehabilitation Facility, which is considered as her primary health care specialty. Craddock, Geraldine Baker can be contacted via phone (859) 255-0890.

Contact Information

Primary practice address
1588 Hill Rise Dr Lexington KY 40504-2587
Phone: (859) 255-0890
Fax: (859) 255-0854
Website:
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Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Substance Abuse Rehabilitation Facility 324500000X ADCLAD00225185 Kentucky
Residential Treatment Facilities / Substance Abuse Rehabilitation Facility 324500000X KY-0001 Kentucky

Profile Details

NPI number 1083982185
LBN Legal business name Craddock, Geraldine Baker
Credentials D.MIN., LCADC, LPC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 5th, 2011
Last updated Apr 13th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1083982185 NPPES
Kentucky MEDICAID 1083982185

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