Provider Demographics
NPI:1982680344
Name:SPILLMAN, CRAIG WARREN (PHD)
Entity type:Individual
Prefix:
First Name:CRAIG
Middle Name:WARREN
Last Name:SPILLMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 W WALNUT HILL LN STE 200
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-3074
Mailing Address - Country:US
Mailing Address - Phone:972-550-8369
Mailing Address - Fax:972-550-8531
Practice Address - Street 1:1300 W WALNUT HILL LN
Practice Address - Street 2:SUITE 200
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038-3007
Practice Address - Country:US
Practice Address - Phone:972-550-8369
Practice Address - Fax:972-550-8531
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2024-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9493101YP2500X, 101YM0800X
TX001278106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist