Craddock, Louis Ray
Craddock, Louis Ray is an sole proprietor health care provider with primary practice located at 800 Seneca Dr , Belpre OH 45714-1141. He recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Forensic, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is his primary health care specialty. Craddock, Louis Ray can be contacted via phone (740) 423-4707.Contact Information
Primary practice address
800 Seneca Dr
Belpre OH 45714-1141
Phone: (740) 423-4707
Fax: (740) 423-6976
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 103TA0400X | 670 | West Virginia |
Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 670 | West Virginia |
Behavioral Health & Social Service Providers / Forensic | 103TF0200X | 670 | West Virginia |
Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 670 | West Virginia |
Profile Details
NPI number | 1629177423 |
---|---|
LBN Legal business name | Craddock, Louis Ray |
Credentials | MS |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Sep 21st, 2006 |
Last updated | Jul 9th, 2007 - about 17 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1629177423 | NPPES |
West Virginia | MEDICAID | 0164801000 |
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