MEDICARE: MRS. STEPHANIE LYNNE CRANE LMSW

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
1	1041C0700X	Clinical Social Worker	6801066373	MI

General Provider Information

NPI Number	:	1609091826
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. STEPHANIE LYNNE CRANE LMSW

Provider Business Mailing Address
First Line	:	21586 WOODCREST CT
Second Line	:
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48335-4242
Country	:	US
Telephone Number	:	248-228-4982
Fax Number	:

Provider Business Practice Location Address
First Line	:	33312 GRAND RIVER AVE STE 102
Second Line	:
City	:	FARMINGTON
State	:	MI
Zip	:	48336-3124
Country	:	US
Telephone Number	:	248-228-4982
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/14/2007
Last Update Date	:	01/04/2023

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