Provider Demographics
NPI:1992794382
Name:CRAIG, WILLIAM SCOTT (PSYD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:SCOTT
Last Name:CRAIG
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 71061
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28272-1061
Mailing Address - Country:US
Mailing Address - Phone:704-721-7430
Mailing Address - Fax:704-721-7431
Practice Address - Street 1:270 COPPERFIELD BLVD NE
Practice Address - Street 2:SUITE 10
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-2442
Practice Address - Country:US
Practice Address - Phone:704-721-7430
Practice Address - Fax:704-721-7431
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1641103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1992794382Medicaid
NC6000383Medicaid
NC1992794382Medicaid