Provider Demographics
NPI:1699940569
Name:CRAIG-MORSE, DAN DAVID (MFT)
Entity type:Individual
Prefix:MR
First Name:DAN
Middle Name:DAVID
Last Name:CRAIG-MORSE
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3281 GRAVENSTEIN HWY N
Mailing Address - Street 2:
Mailing Address - City:SEBASTOPOL
Mailing Address - State:CA
Mailing Address - Zip Code:95472-2326
Mailing Address - Country:US
Mailing Address - Phone:707-824-9803
Mailing Address - Fax:
Practice Address - Street 1:532 COLLEGE AVE STE 6
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95404-4117
Practice Address - Country:US
Practice Address - Phone:707-824-9803
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-23
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42865106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist