Healthcare Provider Details

I. General information

NPI: 1982368825
Provider Name (Legal Business Name): ALESSANDRA ROSE CRIMI LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2021
Last Update Date: 10/27/2021
Certification Date: 10/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 AARON CT
KINGSTON NY
12401-2963
US

IV. Provider business mailing address

10 HAWK HILL RD
NEW PALTZ NY
12561-3800
US

V. Phone/Fax

Practice location:
  • Phone: 845-331-1815
  • Fax:
Mailing address:
  • Phone: 845-256-0774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number110828-01
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number3118214
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: