Individual provider Active NPI

Ann Marie Crescent, LCSW

  • Clinical Social Worker
  • Watertown, NY
National Provider Identifier
1417465089
Registry record updated Feb 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
101947 Issued in NY
Practice address
650 State St.
Watertown, NY 13601-1251
Phone
(518) 353-8054
NPI assigned
Jan 17, 2018
Last updated
Feb 4, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-15-01468 NY
Clinical Social Worker 1041C0700X 101947 NY Primary
Social Worker 104100000X 109119 NY

Addresses

Primary practice location

650 State St.
Watertown, NY 13601-1251

Mailing address

650 State St
Watertown, NY 13601-2839
Phone (518) 353-8054

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260507001069 NY Practitioner - Clinical Social Worker 8123596251 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Suite 608
Malone, NY 12953

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
109119NYMDSocial Worker
101947NYMDClinical Social Worker
RBT-15-01468NYMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Exceptional Kidz Rehabilitation Clinical Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1516147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770163200000",
    "number": "1417465089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 STATE ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136012839",
            "telephone_number": "518-353-8054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 STATE ST.",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136011251",
            "telephone_number": "518-353-8054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRESCENT",
        "first_name": "ANN MARIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-17",
        "last_updated": "2026-02-04",
        "certification_date": "2026-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NY",
            "license": "RBT-15-01468",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "101947",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "109119",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, NY

Sources for this page

Verify at the official NPI Registry.