Provider Demographics
NPI:1932619061
Name:WARNER, CRAIG M (LCSW)
Entity type:Individual
Prefix:
First Name:CRAIG
Middle Name:M
Last Name:WARNER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 S PRIMROSE DR
Mailing Address - Street 2:
Mailing Address - City:COAL CITY
Mailing Address - State:IL
Mailing Address - Zip Code:60416-4102
Mailing Address - Country:US
Mailing Address - Phone:815-405-7100
Mailing Address - Fax:
Practice Address - Street 1:150 S PRIMROSE DR
Practice Address - Street 2:
Practice Address - City:COAL CITY
Practice Address - State:IL
Practice Address - Zip Code:60416-4102
Practice Address - Country:US
Practice Address - Phone:815-405-7100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-03
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL32998101Y00000X, 101YM0800X, 101YA0400X
IL1490267251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical