Healthcare Provider Details

I. General information

NPI: 1033206214
Provider Name (Legal Business Name): LORI LEE CRANE LSCSW, LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LORI LEE JENSEN BSW, MSW

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 08/16/2023
Certification Date: 08/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15510 STATE AVE STE 5D
BASEHOR KS
66007-7122
US

IV. Provider business mailing address

15510 STATE AVE STE 5D
BASEHOR KS
66007-7122
US

V. Phone/Fax

Practice location:
  • Phone: 913-608-9616
  • Fax:
Mailing address:
  • Phone: 913-608-9616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2532
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: