Provider Demographics
NPI:1053198564
Name:CROCIATI, KRISTEN ANN (MA, CAGS, LMHC-A)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:ANN
Last Name:CROCIATI
Suffix:
Gender:F
Credentials:MA, CAGS, LMHC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39A INDUSTRIAL PARK RD
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-4868
Mailing Address - Country:US
Mailing Address - Phone:774-552-5993
Mailing Address - Fax:
Practice Address - Street 1:39A INDUSTRIAL PARK RD
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-4868
Practice Address - Country:US
Practice Address - Phone:774-522-5993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMHC00033-A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health