Provider Demographics
NPI:1154558427
Name:CRAIG, MARCELLE JANAE (MS)
Entity type:Individual
Prefix:MS
First Name:MARCELLE
Middle Name:JANAE
Last Name:CRAIG
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:MARCELLE
Other - Middle Name:JANAE
Other - Last Name:VAN BUREN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:11152 WESTHEIMER RD # 842
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77042-3208
Mailing Address - Country:US
Mailing Address - Phone:713-510-3354
Mailing Address - Fax:
Practice Address - Street 1:265 HENRY ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002
Practice Address - Country:US
Practice Address - Phone:415-668-5955
Practice Address - Fax:415-668-0246
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-15
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist