Provider Demographics
NPI:1487934592
Name:MCCRONE, LOIS A (MA, LPC)
Entity type:Individual
Prefix:MS
First Name:LOIS
Middle Name:A
Last Name:MCCRONE
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1750 E GRAND RIVER AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-4958
Mailing Address - Country:US
Mailing Address - Phone:517-333-7113
Mailing Address - Fax:517-333-7125
Practice Address - Street 1:1750 E GRAND RIVER AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-4958
Practice Address - Country:US
Practice Address - Phone:517-333-7113
Practice Address - Fax:517-333-7125
Is Sole Proprietor?:No
Enumeration Date:2011-08-19
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401013729101YP2500X
TX65816101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2829715-01Medicaid
TX8096LCOtherBC/BS