Provider Demographics
NPI:1497009476
Name:CROSSEN, KRISTEN R (LICSW)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:R
Last Name:CROSSEN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 CEDAR ROAD
Mailing Address - Street 2:
Mailing Address - City:HOLDEN
Mailing Address - State:MA
Mailing Address - Zip Code:01520
Mailing Address - Country:US
Mailing Address - Phone:978-598-3250
Mailing Address - Fax:
Practice Address - Street 1:49 CEDAR ROAD
Practice Address - Street 2:
Practice Address - City:HOLDEN
Practice Address - State:MA
Practice Address - Zip Code:01520
Practice Address - Country:US
Practice Address - Phone:978-598-3250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-30
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1169461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical