Provider Demographics
NPI:1275683955
Name:CROSSROADS COUNSELING CENTER, LLC
Entity Type:Organization
Organization Name:CROSSROADS COUNSELING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COOWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:YVETE
Authorized Official - Middle Name:COOK
Authorized Official - Last Name:SAEUGLING
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:563-556-0699
Mailing Address - Street 1:909 MAIN ST
Mailing Address - Street 2:STE. 505
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52001-6712
Mailing Address - Country:US
Mailing Address - Phone:563-556-0699
Mailing Address - Fax:563-583-3077
Practice Address - Street 1:909 MAIN ST
Practice Address - Street 2:STE. 505
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-6712
Practice Address - Country:US
Practice Address - Phone:563-556-0699
Practice Address - Fax:563-583-3077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01658101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty