Provider Demographics
NPI:1992330161
Name:LESLIE R. CRANE, MS, LMFT, PLLC
Entity type:Organization
Organization Name:LESLIE R. CRANE, MS, LMFT, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CRANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-657-4376
Mailing Address - Street 1:3033 NW 63RD ST STE 165E
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73116-3634
Mailing Address - Country:US
Mailing Address - Phone:405-657-4376
Mailing Address - Fax:405-562-1975
Practice Address - Street 1:3033 NW 63RD ST STE 165E
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-3634
Practice Address - Country:US
Practice Address - Phone:405-657-4376
Practice Address - Fax:405-562-1975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-09
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)