Provider Demographics
NPI:1124664149
Name:CRANE, JUDITH TAYLOR (LMHC, ICADC, CSAT)
Entity type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:TAYLOR
Last Name:CRANE
Suffix:
Gender:F
Credentials:LMHC, ICADC, CSAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 190
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34489-0190
Mailing Address - Country:US
Mailing Address - Phone:352-572-0590
Mailing Address - Fax:352-509-5891
Practice Address - Street 1:3230 NE 55TH AVE
Practice Address - Street 2:
Practice Address - City:SILVER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34488-1721
Practice Address - Country:US
Practice Address - Phone:855-483-7800
Practice Address - Fax:352-509-5891
Is Sole Proprietor?:No
Enumeration Date:2019-11-25
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
FLMH5817101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)