B. Robert Crago PHD PC
Organization Active NPI Clinical Psychologist · Tucson, AZ
NPI 1003476292 · NPPES record last updated Jun 19, 2019
Key facts
- NPI
- 1003476292
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Psychologist 103TC0700X
- Legal business name
- B. ROBERT CRAGO PHD PC
- Practice address
- 5363 E Pima St Ste 100
Tucson, AZ 85712-3663 - Phone
- (520) 323-0062
- Fax
- (520) 323-1336
- NPI assigned
- Jun 19, 2019
- Organization subpart
- No
Authorized official
- Name
- Byrl Robert Crago, PHD
- Title
- President
- Phone
- (520) 323-0062
Practitioners 1
-
Byrl Robert Crago, PHD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200221000786 | AZ | Part B Supplier - Clinic/Group Practice | 1254768716 |
Receives reassigned benefits from 1 practitioner Practice locations: Tucson, AZ |
National Provider Directory
Locations
255 N Rosemont Blvd
Unit 12662
Tucson, AZ 85732
5210 E Pima St
Ste 200
Tucson, AZ 85712
Phone (520) 271-6506
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist |
103TC0700X | Yes |
Addresses
Primary practice location
5363 E Pima St Ste 100
Tucson, AZ 85712-3663
Mailing address
5363 E Pima St Ste 100
Tucson, AZ 85712-3663
Phone (520) 323-0062
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 19, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.