Provider Demographics
NPI:1073388708
Name:CROSSROADS COUNSELING
Entity Type:Organization
Organization Name:CROSSROADS COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:SPRAGUE
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LCPC
Authorized Official - Phone:208-365-3141
Mailing Address - Street 1:829B S WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:EMMETT
Mailing Address - State:ID
Mailing Address - Zip Code:83617-3528
Mailing Address - Country:US
Mailing Address - Phone:208-365-3141
Mailing Address - Fax:208-398-8311
Practice Address - Street 1:829B S WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:EMMETT
Practice Address - State:ID
Practice Address - Zip Code:83617-3528
Practice Address - Country:US
Practice Address - Phone:208-365-3141
Practice Address - Fax:208-398-8311
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JILL J SPRAGUE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-11-22
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management