Provider Demographics
NPI:1275015166
Name:CRAIG, PAYTON (BCBA 1-20-42624)
Entity type:Individual
Prefix:
First Name:PAYTON
Middle Name:
Last Name:CRAIG
Suffix:
Gender:F
Credentials:BCBA 1-20-42624
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 W STATE HIGHWAY 6
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712-3775
Mailing Address - Country:US
Mailing Address - Phone:254-300-5090
Mailing Address - Fax:866-790-8027
Practice Address - Street 1:900 W STATE HIGHWAY 6
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712-3775
Practice Address - Country:US
Practice Address - Phone:254-300-5090
Practice Address - Fax:866-790-8027
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-06
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1863665106S00000X
TX1-20-42624103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1-20-42624OtherBACB
TX1863665OtherBACB