Provider Demographics
NPI:1528713658
Name:CRAHAN, ANNA KUJACZNSKI (MSW)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:KUJACZNSKI
Last Name:CRAHAN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:MARGUERITE
Other - Last Name:KUJACZNSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4666 RAVINE RD
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49006-1042
Mailing Address - Country:US
Mailing Address - Phone:269-251-1850
Mailing Address - Fax:
Practice Address - Street 1:1903 W MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49008-5200
Practice Address - Country:US
Practice Address - Phone:269-387-1850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-17
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68511098171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical