Healthcare Provider Details

I. General information

NPI: 1407764095
Provider Name (Legal Business Name): AMY CRISMOND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 CONGRESS ST
MILFORD MA
01757-4130
US

IV. Provider business mailing address

1202 OLD BRIDGE LN
BELLINGHAM MA
02019-3128
US

V. Phone/Fax

Practice location:
  • Phone: 508-422-0242
  • Fax:
Mailing address:
  • Phone: 508-733-6970
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: