Provider Demographics
NPI:1497009476
Name:CROSSEN, KRISTEN R (LICSW)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:R
Last Name:CROSSEN
Suffix:
Gender:
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 SHORT LEAF DR
Mailing Address - Street 2:
Mailing Address - City:BUDA
Mailing Address - State:TX
Mailing Address - Zip Code:78610-2568
Mailing Address - Country:US
Mailing Address - Phone:774-345-9506
Mailing Address - Fax:
Practice Address - Street 1:204 SHORT LEAF DR
Practice Address - Street 2:
Practice Address - City:BUDA
Practice Address - State:TX
Practice Address - Zip Code:78610-2568
Practice Address - Country:US
Practice Address - Phone:774-345-9506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-30
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1169461041C0700X
TX1051141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical