Provider Demographics
NPI:1457461972
Name:CROSSROADS COUNSELING AND CONSULTING ASSOCIATES
Entity Type:Organization
Organization Name:CROSSROADS COUNSELING AND CONSULTING ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JASBIR
Authorized Official - Middle Name:S
Authorized Official - Last Name:KANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-942-3996
Mailing Address - Street 1:615 E MCMURRAY RD
Mailing Address - Street 2:
Mailing Address - City:MCMURRAY
Mailing Address - State:PA
Mailing Address - Zip Code:15317-3497
Mailing Address - Country:US
Mailing Address - Phone:724-942-3996
Mailing Address - Fax:724-942-5471
Practice Address - Street 1:615 E MCMURRAY RD
Practice Address - Street 2:
Practice Address - City:MCMURRAY
Practice Address - State:PA
Practice Address - Zip Code:15317-3497
Practice Address - Country:US
Practice Address - Phone:724-942-3996
Practice Address - Fax:724-942-5471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA727403UPDMedicare ID - Type UnspecifiedGROUP MEDICARE NUMBER
PAKA727403Medicare UPIN