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CRAFT BEHAVIORAL HEALTH CLINIC
NPI 1184308108
Technician in Jacksonville, FL

Active since June 12, 2023CLIA 10D2090068 · Waiver
10175 FORTUNE PKWY UNIT 1106, JACKSONVILLE, FL 32256(904) 337-0768(904) 379-5967 Get Directions Write a Review

NPPES record last updated: June 12, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Craft Behavioral Health Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CRAFT BEHAVIORAL HEALTH CLINIC (NPI 1184308108), doing business as Craft Laser Clinic, is a healthcare organization registered as a technician in Jacksonville, Florida and active in the NPI registry since June 2023. The organization holds a CLIA Waiver certificate valid through January 13, 2027 and lists Mohammed Farooque, Owner/doctor, as its authorized official.

NPPES Registry Identity

NPI1184308108
Entity TypeOrganization
Primary Taxonomy374700000X
Legal Business NameCRAFT BEHAVIORAL HEALTH CLINIC
Location Address10175 FORTUNE PKWY UNIT 1106Jacksonville, FL 32256-6757
Mailing Address10175 Fortune Pkwy Unit 1106Jacksonville, FL 32256-6757 · (904) 337-0768 · Fax (904) 379-5967
Phone(904) 337-0768
Fax(904) 379-5967
Organization SubpartNo
Authorized OfficialMohammed FarooqueOwner/doctor · (904) 379-5928
Enumeration DateJune 12, 2023
NPPES CertifiedJune 10, 2023
✔ NPI 1184308108 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyTechnicianNursing Service Related Providers
Taxonomy Code374700000X
Definition
(1) A person with specialized training in a narrow field of expertise whose occupation requires training and is skilled in specific technical processes and procedures. (2) An individual having special skill or practical knowledge in an area, such as operation and maintenance of equipment or performance of laboratory procedures involving biochemical analyses. Special technical qualifications are normally required, though an increasing number or technicians also possess university degrees in science, and occasionally doctorate degrees. The distinction between technician and technologist in the health care field is not always clear.
10175 FORTUNE PKWY UNIT 1106, Jacksonville, FL 32256
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Other Names 1

Doing Business AsCraft Laser Clinic

Other Identifiers 1

OtherEO2233FL · Department Of Health Electrologist License

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2090068

Craft Behavioral Health LLC · Jacksonville, FL
Active · expires Jan 13, 2027
CLIA Number10D2090068
Laboratory TypePhysician Office
Certificate Effective DateJanuary 14, 2025
Certificate Expiration DateJanuary 13, 2027
Laboratory DirectorMohammad Forooque
Laboratory Phone(904) 379-5928
Laboratory LocationCraft Behavioral Health LLC10175 Fortune Pkwy Ste 1106, Jacksonville, FL 32256
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SOHAIL A KHAN PA
Hospitalist
10175 FORTUNE PKWY UNIT 1106
JACKSONVILLE, FL 32256
Duval County (904) 379-5928
MS. RANDI AMBER DOPSON LMA, CE, CME
Specialist
10175 FORTUNE PKWY UNIT 1106
JACKSONVILLE, FL 32256
Duval County (904) 470-0589
KAREN KLEIN M.S.
Counselor (Mental Health)
10175 FORTUNE PKWY UNIT 1106
JACKSONVILLE, FL 32256
Duval County (904) 614-2353

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Craft Behavioral Health Clinic's NPI number?

The NPI number for Craft Behavioral Health Clinic is 1184308108. It was assigned to this organization in the NPPES registry on June 12, 2023. The provider is doing business as Craft Laser Clinic.

Where is Craft Behavioral Health Clinic located?

Craft Behavioral Health Clinic is located at 10175 Fortune Pkwy Unit 1106, Jacksonville, FL 32256. The listed phone number is (904) 337-0768.

What is Craft Behavioral Health Clinic's specialty?

The primary specialty registered for this NPI is Technician with taxonomy code 374700000X.

Does Craft Behavioral Health Clinic hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2090068) is associated with this NPI, valid through January 13, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Craft Behavioral Health Clinic was last updated on June 12, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.