Provider Demographics
NPI:1285960518
Name:CHILDS, CRAIG D (PHD)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:D
Last Name:CHILDS
Suffix:
Gender:
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:385 WILLIAMSTOWNE STE 301
Mailing Address - Street 2:
Mailing Address - City:DELAFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53018-2323
Mailing Address - Country:US
Mailing Address - Phone:262-646-6404
Mailing Address - Fax:262-533-0056
Practice Address - Street 1:385 WILLIAMSTOWNE STE 301
Practice Address - Street 2:
Practice Address - City:DELAFIELD
Practice Address - State:WI
Practice Address - Zip Code:53018-2323
Practice Address - Country:US
Practice Address - Phone:262-646-6404
Practice Address - Fax:262-533-0056
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-21
Last Update Date:2025-03-05
Deactivation Date:2013-05-28
Deactivation Code:
Reactivation Date:2013-06-20
Provider Licenses
StateLicense IDTaxonomies
WI2834-057103TB0200X, 103TC1900X, 103TF0200X, 103TH0004X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth