Provider Demographics
NPI:1669862207
Name:CROSSROADS EDUCATION & WELLNESS SERVICES, LLC
Entity Type:Organization
Organization Name:CROSSROADS EDUCATION & WELLNESS SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST / OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARKELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HANDY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:301-751-5859
Mailing Address - Street 1:7711 ANNAPOLIS ROAD
Mailing Address - Street 2:PO BOX 425
Mailing Address - City:ODENTON
Mailing Address - State:MD
Mailing Address - Zip Code:21113
Mailing Address - Country:US
Mailing Address - Phone:301-751-5859
Mailing Address - Fax:
Practice Address - Street 1:1616 H ST NW
Practice Address - Street 2:#106
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006-4903
Practice Address - Country:US
Practice Address - Phone:301-751-5859
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-04
Last Update Date:2015-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC14434101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty