Provider Demographics
NPI:1205109907
Name:CRISPINO, ANNMARIE SHENTON (LCSW)
Entity type:Individual
Prefix:MS
First Name:ANNMARIE
Middle Name:SHENTON
Last Name:CRISPINO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 159
Mailing Address - Street 2:
Mailing Address - City:GARDINER
Mailing Address - State:NY
Mailing Address - Zip Code:12525-0159
Mailing Address - Country:US
Mailing Address - Phone:845-581-0015
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 159
Practice Address - Street 2:
Practice Address - City:GARDINER
Practice Address - State:NY
Practice Address - Zip Code:12525-0159
Practice Address - Country:US
Practice Address - Phone:845-581-0015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-12
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC05494900101YM0800X
NY0841691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health