Provider Demographics
NPI:1043369077
Name:CROSS KEYS COUNSELING CENTER, INC.
Entity Type:Organization
Organization Name:CROSS KEYS COUNSELING CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF THERAPY SERVICES
Authorized Official - Prefix:DR
Authorized Official - First Name:DORIS
Authorized Official - Middle Name:WOODRUFF
Authorized Official - Last Name:HEWITT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:404-366-3420
Mailing Address - Street 1:1035 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FOREST PARK
Mailing Address - State:GA
Mailing Address - Zip Code:30297-1441
Mailing Address - Country:US
Mailing Address - Phone:404-366-3420
Mailing Address - Fax:404-608-1365
Practice Address - Street 1:1035 MAIN ST
Practice Address - Street 2:
Practice Address - City:FOREST PARK
Practice Address - State:GA
Practice Address - Zip Code:30297-1441
Practice Address - Country:US
Practice Address - Phone:404-366-3420
Practice Address - Fax:404-608-1365
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1569103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty