Michelle Dawn Craig, MA, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

C3654 Issued in OR

Practice address

12636 SE Stark St BLDG J
Portland, OR 97233-1058

Phone

(503) 253-4600

Fax

(503) 253-4609

NPI assigned

Oct 13, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Michelle Grove Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Interoperability endpoints

• Direct secure messaging: lifestancehealth.michellecraig@148835.advancedmd-direct.com
• Direct secure messaging: michelle.craig.p1@direct.sokya.nextgenshare.com

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425340800000",
    "number": "1255421160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12636 SE STARK ST BLDG J",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972331058",
            "telephone_number": "503-253-4600",
            "fax_number": "503-253-4609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12636 SE STARK ST BLDG J",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972331058",
            "telephone_number": "503-253-4600",
            "fax_number": "503-253-4609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAIG",
        "first_name": "MICHELLE",
        "middle_name": "DAWN",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2015-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C3654",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401007719",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "GROVE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Desiree Rose Craig
• Jerome Gavin Craig, DC, LMT
• Justine Craig
• Megan Craig, LMFT
• Michelle Craig, BS
• Miles Ericson Craig
• Neal Alex Craig, D.C.
• Nicole L Craig, MA, LPC, CADCI
• Rachel Craig, LMT
• Sarah Elaine Craig

• Professional Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Professional Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2015; 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.