Provider Demographics
NPI:1962092460
Name:CRAIG, JANET BERDAHL (LCSW)
Entity type:Individual
Prefix:MRS
First Name:JANET
Middle Name:BERDAHL
Last Name:CRAIG
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 SIERRA DR
Mailing Address - Street 2:
Mailing Address - City:GLEN CARBON
Mailing Address - State:IL
Mailing Address - Zip Code:62034-1314
Mailing Address - Country:US
Mailing Address - Phone:618-520-6236
Mailing Address - Fax:
Practice Address - Street 1:20 SIERRA DR
Practice Address - Street 2:
Practice Address - City:GLEN CARBON
Practice Address - State:IL
Practice Address - Zip Code:62034-1314
Practice Address - Country:US
Practice Address - Phone:618-520-6236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-19
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490005311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical