Provider Demographics
NPI:1629280821
Name:CROSSINGS COUNSELING CENTER, INC.
Entity Type:Organization
Organization Name:CROSSINGS COUNSELING CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:SLIGAR
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:770-314-8247
Mailing Address - Street 1:5575 PEACHTREE PKWY
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30092-2551
Mailing Address - Country:US
Mailing Address - Phone:770-314-8247
Mailing Address - Fax:
Practice Address - Street 1:5575 PEACHTREE PKWY
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30092-2551
Practice Address - Country:US
Practice Address - Phone:770-314-8247
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMFT000568106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty