Provider Demographics
NPI:1174549687
Name:PARKER, CRAIG LUTHER (LPC)
Entity type:Individual
Prefix:
First Name:CRAIG
Middle Name:LUTHER
Last Name:PARKER
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 1:137 LAXTON RD
Mailing Address - Street 2:SUITE 360
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-3144
Mailing Address - Country:US
Mailing Address - Phone:434-237-0155
Mailing Address - Fax:434-237-0032
Practice Address - Street 1:137 LAXTON RD
Practice Address - Street 2:SUITE 360
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-3144
Practice Address - Country:US
Practice Address - Phone:434-237-0155
Practice Address - Fax:434-237-0032
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701002436101YP2500X
VA0717000406106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA17494OtherMENNINGER CARE SYSTEMS
VA5406153Medicaid
VA117126OtherBEHAVIORAL HEALTH NETWORK
VA081026OtherSENTARA PROVIDER #
VA1054367OtherCIGNA PROVIDER #
VA19555OtherHRI PROVIDER #
VA323150OtherANTHEM BC/BS PROVIDER #
VA1054367OtherMCC BEHAVIORAL PROVIDER #
VA57517OtherHORIZONS PROVIDER #
VA135110OtherCOMPSYCH PROVIDER #
VA19497OtherHRI PROVIDER #