Provider Demographics
NPI:1013419787
Name:CRANE, DAMARYS (MASTERS)
Entity Type:Individual
Prefix:MRS
First Name:DAMARYS
Middle Name:
Last Name:CRANE
Suffix:
Gender:F
Credentials:MASTERS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2219 NW 135TH TER
Mailing Address - Street 2:
Mailing Address - City:OPA LOCKA
Mailing Address - State:FL
Mailing Address - Zip Code:33054-4020
Mailing Address - Country:US
Mailing Address - Phone:786-617-3299
Mailing Address - Fax:
Practice Address - Street 1:12001 SW 128TH CT STE 101
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-4665
Practice Address - Country:US
Practice Address - Phone:786-975-7485
Practice Address - Fax:954-860-7166
Is Sole Proprietor?:No
Enumeration Date:2018-03-08
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL103K00000X
101Y00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101Y00000XBehavioral Health & Social Service ProvidersCounselor