Provider Demographics
NPI:1881390409
Name:CRAIG, JESSICA (MA, LBS, NCC, LPC)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:CRAIG
Suffix:
Gender:F
Credentials:MA, LBS, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 ROBISON RD W
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16509-5418
Mailing Address - Country:US
Mailing Address - Phone:814-882-3729
Mailing Address - Fax:
Practice Address - Street 1:70 ROBISON RD W
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16509-5418
Practice Address - Country:US
Practice Address - Phone:814-882-3729
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-06
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH000361103K00000X
PAPC018746101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst