Basic Information
| Provider Information | |||||||||
| NPI: | 1790726529 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CRANSTON | ||||||||
| FirstName: | MICHAEL | ||||||||
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| Credential: | LCMFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 747 | ||||||||
| Address2: | |||||||||
| City: | MANHATTAN | ||||||||
| State: | KS | ||||||||
| PostalCode: | 665050747 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7855874346 | ||||||||
| FaxNumber: | 7855874377 | ||||||||
| Practice Location | |||||||||
| Address1: | 2001 CLAFLIN RD | ||||||||
| Address2: | |||||||||
| City: | MANHATTAN | ||||||||
| State: | KS | ||||||||
| PostalCode: | 665023415 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7855874310 | ||||||||
| FaxNumber: | 7855874305 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/10/2006 | ||||||||
| LastUpdateDate: | 04/22/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | 226 | KS | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
ID Information
| ID | Type | State | Issuer | Description | 070062 | 01 | KS | BCBS NUMBER | OTHER |