MEDICARE: CRANE'S COUNSELING LLC

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	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1669077236
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CRANE'S COUNSELING LLC

Provider Business Mailing Address
First Line	:	2600 S LOOP W STE 475B
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-2681
Country	:	US
Telephone Number	:	832-720-2149
Fax Number	:	877-883-8370

Provider Business Practice Location Address
First Line	:	2600 S LOOP W STE 475B
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-2681
Country	:	US
Telephone Number	:	832-720-2149
Fax Number	:	877-883-8370

Authorized Official
Title or Position	:	OWNER
Name	:	MR. DOMONICK FITZGERALD CRANE SR.
Credential	:	LPC
Telephone Number	:	832-720-2149

Provider Enumeration Date	:	12/02/2020
Last Update Date	:	12/02/2020

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Directions to “CRANE'S COUNSELING LLC ” Practice Location

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