Provider Demographics
NPI:1801048244
Name:CROSSROADS PROFESSIONAL COUNSELING
Entity type:Organization
Organization Name:CROSSROADS PROFESSIONAL COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SPRINGGAY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:480-558-5112
Mailing Address - Street 1:1400 N GILBERT RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-2328
Mailing Address - Country:US
Mailing Address - Phone:480-558-5112
Mailing Address - Fax:480-558-7612
Practice Address - Street 1:1400 N GILBERT RD
Practice Address - Street 2:SUITE B
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-2328
Practice Address - Country:US
Practice Address - Phone:480-558-5112
Practice Address - Fax:480-558-7612
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-16
Last Update Date:2012-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ12839101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty