Provider Demographics
NPI:1366806689
Name:CRAVEN, DRESA DELANE (MSW, LCSW, CPM)
Entity type:Individual
Prefix:MRS
First Name:DRESA
Middle Name:DELANE
Last Name:CRAVEN
Suffix:
Gender:F
Credentials:MSW, LCSW, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 SHERWOOD LN
Mailing Address - Street 2:
Mailing Address - City:CHATTAHOOCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:32324-1913
Mailing Address - Country:US
Mailing Address - Phone:850-570-8733
Mailing Address - Fax:
Practice Address - Street 1:1105 SHERWOOD LN
Practice Address - Street 2:
Practice Address - City:CHATTAHOOCHEE
Practice Address - State:FL
Practice Address - Zip Code:32324-1913
Practice Address - Country:US
Practice Address - Phone:850-570-8733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-12
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 110451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical