Provider Demographics
NPI:1619259967
Name:CRANCH, JENNIFER A (LMSW)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:A
Last Name:CRANCH
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1545 SAINT PAUL ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14621-3156
Mailing Address - Country:US
Mailing Address - Phone:585-336-5867
Mailing Address - Fax:585-336-5880
Practice Address - Street 1:1545 SAINT PAUL ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621-3156
Practice Address - Country:US
Practice Address - Phone:585-336-5867
Practice Address - Fax:585-336-5880
Is Sole Proprietor?:No
Enumeration Date:2011-09-13
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0528561041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool