Provider Demographics
NPI:1114647260
Name:CROSS COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:CROSS COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPC
Authorized Official - Prefix:
Authorized Official - First Name:DATONNA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:CROSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:539-867-3015
Mailing Address - Street 1:PO BOX 52173
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74152-0173
Mailing Address - Country:US
Mailing Address - Phone:539-867-3015
Mailing Address - Fax:
Practice Address - Street 1:4124 E 35TH ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-1704
Practice Address - Country:US
Practice Address - Phone:479-388-8383
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-30
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty