Provider Demographics
NPI:1114151594
Name:CROSSROADS COUNSELING, P.C.
Entity Type:Organization
Organization Name:CROSSROADS COUNSELING, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:DELPILAR
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:910-431-5505
Mailing Address - Street 1:5813 WRIGHTSVILLE AVE APT 170
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-6527
Mailing Address - Country:US
Mailing Address - Phone:910-350-1181
Mailing Address - Fax:910-350-0419
Practice Address - Street 1:4320 WRIGHTSVILLE AVE
Practice Address - Street 2:SUITE B
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-6336
Practice Address - Country:US
Practice Address - Phone:910-350-1181
Practice Address - Fax:910-350-0419
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-13
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1814103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty