Provider Demographics
NPI:1356962286
Name:CROUCH, CYRA LAINE (LPC)
Entity type:Individual
Prefix:
First Name:CYRA
Middle Name:LAINE
Last Name:CROUCH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1112 ARMADILLO TRL
Mailing Address - Street 2:
Mailing Address - City:LANTANA
Mailing Address - State:TX
Mailing Address - Zip Code:76226-2645
Mailing Address - Country:US
Mailing Address - Phone:832-421-5223
Mailing Address - Fax:
Practice Address - Street 1:2201 SPINKS RD STE 201
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75022-4451
Practice Address - Country:US
Practice Address - Phone:832-421-5223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-01
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80357101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional