Healthcare Provider Details

I. General information

NPI: 1235052820
Provider Name (Legal Business Name): LAURA DUFFY CRANK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2026
Last Update Date: 08/01/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

126 LITHIA PINECREST RD
BRANDON FL
33511-5347
US

IV. Provider business mailing address

10921 BRIGHTLEAF CT
RIVERVIEW FL
33569-5646
US

V. Phone/Fax

Practice location:
  • Phone: 813-689-8828
  • Fax:
Mailing address:
  • Phone: 660-441-3026
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number29586
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: