Provider Demographics
NPI:1023498755
Name:DALTON, CRAIG KENT (LPC)
Entity type:Individual
Prefix:
First Name:CRAIG
Middle Name:KENT
Last Name:DALTON
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36275 N GANTZEL RD
Mailing Address - Street 2:102
Mailing Address - City:SAN TAN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85140-7320
Mailing Address - Country:US
Mailing Address - Phone:480-590-7147
Mailing Address - Fax:480-590-3495
Practice Address - Street 1:690 E WARNER RD STE 115
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296-3056
Practice Address - Country:US
Practice Address - Phone:480-444-2434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-08
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
AZLPC-17854101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional