Provider Demographics
NPI:1356743587
Name:CRANE, JEFFERY JOSEPH (LPCC)
Entity type:Individual
Prefix:MR
First Name:JEFFERY
Middle Name:JOSEPH
Last Name:CRANE
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 N RACE ST
Mailing Address - Street 2:
Mailing Address - City:GLASGOW
Mailing Address - State:KY
Mailing Address - Zip Code:42141-2816
Mailing Address - Country:US
Mailing Address - Phone:270-629-6373
Mailing Address - Fax:270-479-1302
Practice Address - Street 1:220 N RACE ST
Practice Address - Street 2:
Practice Address - City:GLASGOW
Practice Address - State:KY
Practice Address - Zip Code:42141-2816
Practice Address - Country:US
Practice Address - Phone:270-629-6373
Practice Address - Fax:270-479-1302
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-18
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0432101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional