Provider Demographics
NPI:1487344057
Name:CRANE, CANDIDA MICHELLE (MED, LMHC)
Entity type:Individual
Prefix:MS
First Name:CANDIDA
Middle Name:MICHELLE
Last Name:CRANE
Suffix:
Gender:F
Credentials:MED, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2717 NE 54TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-3149
Mailing Address - Country:US
Mailing Address - Phone:425-749-8559
Mailing Address - Fax:
Practice Address - Street 1:2717 NE 54TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-3149
Practice Address - Country:US
Practice Address - Phone:425-749-8559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-08
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60664702101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health