Provider Demographics
NPI:1194469775
Name:CROFT, KYRIAN JENNA (LMHC)
Entity type:Individual
Prefix:
First Name:KYRIAN
Middle Name:JENNA
Last Name:CROFT
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:KYRIAN
Other - Middle Name:
Other - Last Name:MARSHALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:10038 MIDNIGHT LINE DR
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46040-6607
Mailing Address - Country:US
Mailing Address - Phone:765-246-3873
Mailing Address - Fax:
Practice Address - Street 1:10038 MIDNIGHT LINE DR
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46040-6607
Practice Address - Country:US
Practice Address - Phone:765-721-0946
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-21
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39004924A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health