Provider Demographics
NPI:1952453714
Name:CRANE, CANAAN R (LMFT)
Entity Type:Individual
Prefix:DR
First Name:CANAAN
Middle Name:R
Last Name:CRANE
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2007 N MINNESOTA AVE
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:OK
Mailing Address - Zip Code:74804-3024
Mailing Address - Country:US
Mailing Address - Phone:405-226-0644
Mailing Address - Fax:
Practice Address - Street 1:1601 N KICKAPOO AVE STE 900
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:OK
Practice Address - Zip Code:74804-4313
Practice Address - Country:US
Practice Address - Phone:405-585-6413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK783106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist