Provider Demographics
NPI:1316401680
Name:RICHARD, CROSS JOSEPH JR
Entity Type:Individual
Prefix:
First Name:CROSS
Middle Name:JOSEPH
Last Name:RICHARD
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17732 HIGHLAND RD # G154
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-3846
Mailing Address - Country:US
Mailing Address - Phone:504-231-4846
Mailing Address - Fax:
Practice Address - Street 1:17732 HIGHLAND RD # G154
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-3846
Practice Address - Country:US
Practice Address - Phone:504-231-4846
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-30
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health