Provider Demographics
NPI:1386422418
Name:GRANTS, CRYSTIN (LMFT)
Entity type:Individual
Prefix:
First Name:CRYSTIN
Middle Name:
Last Name:GRANTS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2625 SUNDANCE CIR
Mailing Address - Street 2:
Mailing Address - City:MULBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:33860-6552
Mailing Address - Country:US
Mailing Address - Phone:813-421-3040
Mailing Address - Fax:
Practice Address - Street 1:255 N KENTUCKY AVE STE 203
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33801-4981
Practice Address - Country:US
Practice Address - Phone:813-421-3040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-19
Last Update Date:2025-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT5307106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist