MEDICARE: CAMILLE CRANE LCSW

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	CW019208	PA
2	1041C0700X	Clinical Social Worker	19367	MD
3	1041C0700X	Clinical Social Worker	LC50080451	DC

General Provider Information

NPI Number	:	1710433180
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAMILLE CRANE LCSW

Provider Business Mailing Address
First Line	:	90 SLOCUM ST
Second Line	:
City	:	FORTY FORT
State	:	PA
Zip	:	18704-4021
Country	:	US
Telephone Number	:	703-585-2221
Fax Number	:

Provider Business Practice Location Address
First Line	:	900 RUTTER AVE
Second Line	:
City	:	KINGSTON
State	:	PA
Zip	:	18704-4962
Country	:	US
Telephone Number	:	570-285-3179
Fax Number	:

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

Provider Enumeration Date	:	08/26/2016
Last Update Date	:	12/15/2025

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Directions to “ CAMILLE CRANE LCSW” Practice Location

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