Provider Demographics
NPI:1710433180
Name:CRANE, CAMILLE (LCSW)
Entity Type:Individual
Prefix:
First Name:CAMILLE
Middle Name:
Last Name:CRANE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 N 4TH ST
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17837-1401
Mailing Address - Country:US
Mailing Address - Phone:703-585-2221
Mailing Address - Fax:
Practice Address - Street 1:8638 ROUTE 104
Practice Address - Street 2:
Practice Address - City:MT PLEASANT MILLS
Practice Address - State:PA
Practice Address - Zip Code:17853-8752
Practice Address - Country:US
Practice Address - Phone:703-585-2221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-26
Last Update Date:2016-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0192081041C0700X
MD193671041C0700X
DCLC500804511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical