Provider Demographics
NPI:1679939029
Name:CRAYTON COUNSELING CENTER, INC.
Entity type:Organization
Organization Name:CRAYTON COUNSELING CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAYTON
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:757-913-9195
Mailing Address - Street 1:22 BELLES COVE DR
Mailing Address - Street 2:APT. C
Mailing Address - City:POQUOSON
Mailing Address - State:VA
Mailing Address - Zip Code:23662-1558
Mailing Address - Country:US
Mailing Address - Phone:757-913-9195
Mailing Address - Fax:
Practice Address - Street 1:825 DILIGENCE DRIVE
Practice Address - Street 2:SUITE 206
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4272
Practice Address - Country:US
Practice Address - Phone:757-310-6900
Practice Address - Fax:757-240-5936
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-14
Last Update Date:2016-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA9040071021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty