Provider Demographics
NPI:1477691608
Name:CROSSROADS COUNSELING, INC.
Entity Type:Organization
Organization Name:CROSSROADS COUNSELING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:781-431-2277
Mailing Address - Street 1:219 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02481-3105
Mailing Address - Country:US
Mailing Address - Phone:781-431-2277
Mailing Address - Fax:781-431-7770
Practice Address - Street 1:219 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02481-3105
Practice Address - Country:US
Practice Address - Phone:781-431-2277
Practice Address - Fax:781-431-7770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP10173Medicare UPIN