Provider Demographics
NPI:1790489607
Name:CRESCI, KATHERINE MAE (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:MAE
Last Name:CRESCI
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 REYNOLDS RD
Mailing Address - Street 2:
Mailing Address - City:FORT EDWARD
Mailing Address - State:NY
Mailing Address - Zip Code:12828-9217
Mailing Address - Country:US
Mailing Address - Phone:518-573-0239
Mailing Address - Fax:518-747-2194
Practice Address - Street 1:46 REYNOLDS RD
Practice Address - Street 2:
Practice Address - City:FORT EDWARD
Practice Address - State:NY
Practice Address - Zip Code:12828-9217
Practice Address - Country:US
Practice Address - Phone:518-573-0239
Practice Address - Fax:518-747-2194
Is Sole Proprietor?:No
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY101440104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker