Provider Demographics
NPI:1578214201
Name:CRANE, JACLYN MARIE (LMHCD)
Entity type:Individual
Prefix:
First Name:JACLYN
Middle Name:MARIE
Last Name:CRANE
Suffix:
Gender:F
Credentials:LMHCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:636 N FRENCH RD STE 8
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14228-1900
Mailing Address - Country:US
Mailing Address - Phone:716-706-4752
Mailing Address - Fax:716-317-7782
Practice Address - Street 1:636 N FRENCH RD STE 8
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14228-1900
Practice Address - Country:US
Practice Address - Phone:716-706-4752
Practice Address - Fax:716-317-7782
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-13
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008547101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health