Provider Demographics
NPI:1861689077
Name:CRAFTON, AMY JO (LPCC, MFT - INTERN)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:JO
Last Name:CRAFTON
Suffix:
Gender:F
Credentials:LPCC, MFT - INTERN
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:HANSON
Other - Last Name:CRAFTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA LPCA
Mailing Address - Street 1:1011 BOWLING GREEN RD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:KY
Mailing Address - Zip Code:42134-1364
Mailing Address - Country:US
Mailing Address - Phone:270-776-5243
Mailing Address - Fax:
Practice Address - Street 1:1011 BOWLING GREEN RD
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:KY
Practice Address - Zip Code:42134-1364
Practice Address - Country:US
Practice Address - Phone:270-776-5243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-02
Last Update Date:2009-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA59611106H00000X
KY0963101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health