Provider Demographics
NPI:1396015038
Name:CROSSROADS COUNSELING LLC
Entity Type:Organization
Organization Name:CROSSROADS COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:GIORDANO
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:732-635-9797
Mailing Address - Street 1:402 MAIN ST STE 201
Mailing Address - Street 2:
Mailing Address - City:METUCHEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08840-1960
Mailing Address - Country:US
Mailing Address - Phone:732-635-9797
Mailing Address - Fax:
Practice Address - Street 1:402 MAIN ST STE 201
Practice Address - Street 2:
Practice Address - City:METUCHEN
Practice Address - State:NJ
Practice Address - Zip Code:08840-1960
Practice Address - Country:US
Practice Address - Phone:732-635-9797
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-11
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty