Healthcare Provider Details

I. General information

NPI: 1538842422
Provider Name (Legal Business Name): KACI ANN CROOK MA, LMHC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KACI ANN RONGE

II. Dates (important events)

Enumeration Date: 08/08/2023
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8588 STARKEY RD STE E
SEMINOLE FL
33777-2831
US

IV. Provider business mailing address

8588 STARKEY RD STE E
SEMINOLE FL
33777-2831
US

V. Phone/Fax

Practice location:
  • Phone: 727-209-7068
  • Fax:
Mailing address:
  • Phone: 727-209-7068
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH25160
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: