Individual provider Active NPI

Connie K Craig, PHD. ARNP

  • Clinical Psychologist
  • Bellevue, WA
National Provider Identifier
1073601068
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY00003200 Issued in WA
Practice address
14929 SE Allen Rd
Bellevue, WA 98006-1639
Phone
(425) 746-2124
Fax
(425) 746-2148
NPI assigned
Oct 11, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY00003200 WA Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP30004761 WA

Addresses

Primary practice location

14929 SE Allen Rd
Bellevue, WA 98006-1639

Mailing address

7460 W Mercer Way
Mercer Island, WA 98040-5537
Phone (206) 406-7539

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY00003200WAMDClinical Psychologist
AP30004761WAMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1073601068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7460 W MERCER WAY",
            "city": "MERCER ISLAND",
            "state": "WA",
            "postal_code": "980405537",
            "telephone_number": "206-406-7539",
            "fax_number": "425-746-2148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14929 SE ALLEN RD",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980061639",
            "telephone_number": "425-746-2124",
            "fax_number": "425-746-2148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAIG",
        "first_name": "CONNIE",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "PHD. ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY00003200",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP30004761",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.