Crescent Wellness, Inc

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

CRESCENT WELLNESS, INC

Practice address

320 Dayton St Ste 127
Edmonds, WA 98020-3590

Phone

(206) 486-0295

NPI assigned

Oct 23, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kelly Druin, LICSWNPI 1649586777

Title

Provider

Phone

(206) 486-0295

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kelly Druin, LICSW

  • Clinical Social Worker
  • Edmonds, WA
  • NPI 1649586777
  Medicare reassignment Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1540252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653177600000",
    "number": "1124594510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 DAYTON ST STE 127",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980203590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 DAYTON ST STE 127",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980203590",
            "telephone_number": "206-486-0295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESCENT WELLNESS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-23",
        "last_updated": "2022-05-22",
        "certification_date": "2022-05-22",
        "status": "A",
        "authorized_official_last_name": "DRUIN",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "206-486-0295",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1649586777",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tani Coxon, LMP
• Judy Ann Craft, L.M.P.
• Barry T Craig, LMP
• Stephanie Cram, ARNP
• Drake William Cramer, DO
• Annalinn Crevoiserat
• Hanna Crews, LMP
• Kimberly Anne Crispeno, LMHCA
• Maurene P Cronyn, M.D.
• Karla Ruth Crouch, OTR/L, MOT

• Mental Health Clinic/Center (Including Community Mental Health Center) in Edmonds, WA
• Providers in Edmonds, WA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.