Provider Demographics
NPI:1447709860
Name:CRAGWELL, OSCAR (LMSW)
Entity type:Individual
Prefix:
First Name:OSCAR
Middle Name:
Last Name:CRAGWELL
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 E 6TH ST
Mailing Address - Street 2:APT 7-I
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-6403
Mailing Address - Country:US
Mailing Address - Phone:917-406-0816
Mailing Address - Fax:
Practice Address - Street 1:250 W 57TH ST
Practice Address - Street 2:SUITE 501
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10107-0001
Practice Address - Country:US
Practice Address - Phone:212-582-1566
Practice Address - Fax:212-586-1272
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-27
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY103TP0814X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysis