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NPI Code Detail

MEDICARE: STACEY VIRGINIA CRANE LPC

MEDICARE: STACEY VIRGINIA CRANE LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor6401010882MI
2101YM0800XMental Health Counselor6401010882MI

General Provider Information

NPI Number : 1932404308
Entity Type Code : Individual
Provider Name (Legal Business Name) : STACEY VIRGINIA CRANE LPC
Provider Business Mailing Address
First Line : 6549 TOWN CENTER DR STE A
Second Line :
City : CLARKSTON
State : MI
Zip : 48346-4824
Country : US
Telephone Number : 800-395-3223
Fax Number : 248-620-6405
Provider Business Practice Location Address
First Line : 8225 MOORSBRIDGE RD
Second Line :
City : PORTAGE
State : MI
Zip : 49024-7845
Country : US
Telephone Number : 800-395-3223
Fax Number : 248-620-6405
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/17/2011
Last Update Date : 01/21/2026

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Directions to “ STACEY VIRGINIA CRANE LPC” Practice Location

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