Provider Demographics
NPI:1881105997
Name:CROSS & ASSOCIATES LLC
Entity type:Organization
Organization Name:CROSS & ASSOCIATES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGUERITE
Authorized Official - Middle Name:
Authorized Official - Last Name:CROSS
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LSWAIC
Authorized Official - Phone:360-742-6351
Mailing Address - Street 1:1515 SINCLAIR DR
Mailing Address - Street 2:
Mailing Address - City:DUPONT
Mailing Address - State:WA
Mailing Address - Zip Code:98327-7756
Mailing Address - Country:US
Mailing Address - Phone:253-221-1855
Mailing Address - Fax:253-320-2145
Practice Address - Street 1:1515 SINCLAIR DR
Practice Address - Street 2:
Practice Address - City:DUPONT
Practice Address - State:WA
Practice Address - Zip Code:98327-7756
Practice Address - Country:US
Practice Address - Phone:360-742-6351
Practice Address - Fax:253-320-2145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-16
Last Update Date:2017-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC607153561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty