Provider Demographics
NPI:1144528019
Name:CRAFT, STEPHANIE L (LISW)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:L
Last Name:CRAFT
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:MRS
Other - First Name:STEPHANIE
Other - Middle Name:L
Other - Last Name:CRAFT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LISW
Mailing Address - Street 1:941 MARKET STREET
Mailing Address - Street 2:
Mailing Address - City:PIKETON
Mailing Address - State:OH
Mailing Address - Zip Code:45661-9757
Mailing Address - Country:US
Mailing Address - Phone:740-289-2371
Mailing Address - Fax:740-289-4291
Practice Address - Street 1:227 VALLEY VIEW DRIVE
Practice Address - Street 2:
Practice Address - City:WAVERLY
Practice Address - State:OH
Practice Address - Zip Code:45690-9135
Practice Address - Country:US
Practice Address - Phone:740-947-7726
Practice Address - Fax:740-947-9354
Is Sole Proprietor?:No
Enumeration Date:2011-03-02
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.1100034-SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0270932Medicaid