Individual provider Active NPI

Kristine Crean

  • Clinical Social Worker
  • Salem, MA
National Provider Identifier
1215703574
Registry record updated Sep 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LICSW1141877 Issued in MA
Practice address
17 Paradise Rd # 1114
Salem, MA 01970-4229
Phone
(617) 299-6578
NPI assigned
Nov 28, 2023
Last updated
Sep 10, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LICSW1141877 MA Primary

Addresses

Primary practice location

17 Paradise Rd # 1114
Salem, MA 01970-4229

Mailing address

17 Paradise Rd
Vinnin Square Plaza #1114
Salem, MA 01970-4229
Phone (617) 299-6578

Other practice location 1

61 Bickford St
Lynn, MA 01904-2005
Phone (617) 299-6578

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LICSW1141877MAMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1701129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788998400000",
    "number": "1215703574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 PARADISE RD",
            "address_2": "VINNIN SQUARE PLAZA #1114",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019704229",
            "telephone_number": "617-299-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 PARADISE RD # 1114",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019704229",
            "telephone_number": "617-299-6578"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "61 Bickford St",
            "address_purpose": "LOCATION",
            "city": "Lynn",
            "state": "MA",
            "postal_code": "019042005",
            "country_code": "US",
            "telephone_number": "617-299-6578",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CREAN",
        "first_name": "KRISTINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-28",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "LICSW1141877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.