Provider Demographics
NPI:1740534775
Name:CROSSPOINT CLINICAL SERVICES, INC
Entity type:Organization
Organization Name:CROSSPOINT CLINICAL SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER/DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:JIMERSON
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:413-636-5691
Mailing Address - Street 1:117 PARK AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:WEST SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01089-3326
Mailing Address - Country:US
Mailing Address - Phone:413-636-5691
Mailing Address - Fax:
Practice Address - Street 1:117 PARK AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:WEST SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01089-3326
Practice Address - Country:US
Practice Address - Phone:413-588-8550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-29
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1141561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty