Active NPI
Jason Craig, LPC, LSSP
- Professional Counselor
- Waco, TX
National Provider Identifier
1972778199
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 17012
- Practice address
- 3621 Lasker Ave
Waco, TX 76707-1111 - Phone
- (254) 235-0382
- NPI assigned
- Apr 29, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 17012 | TX | Primary |
| School Psychologist | 103TS0200X | 32607 | TX |
Addresses
Primary practice location
3621 Lasker Ave
Waco, TX 76707-1111
Mailing address
3000 Pine Ave
Waco, TX 76708
Phone (254) 855-5103
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17012 | TX | MD | Professional Counselor |
| 32607 | TX | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209427200000",
"number": "1972778199",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3000 PINE AVE",
"city": "WACO",
"state": "TX",
"postal_code": "76708",
"telephone_number": "254-855-5103"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3621 LASKER AVE",
"city": "WACO",
"state": "TX",
"postal_code": "767071111",
"telephone_number": "254-235-0382"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRAIG",
"first_name": "JASON",
"credential": "LPC, LSSP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-04-29",
"last_updated": "2008-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "17012",
"primary": true
},
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "TX",
"license": "32607",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waco, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.