Provider Demographics
NPI:1881744597
Name:CROSSINGS COUNSELING CENTER INC
Entity type:Organization
Organization Name:CROSSINGS COUNSELING CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MARRIAGE AND FAMILY THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:BERNARD
Authorized Official - Last Name:KYNES
Authorized Official - Suffix:SR
Authorized Official - Credentials:M DIV
Authorized Official - Phone:404-378-2232
Mailing Address - Street 1:209 SWANTON WAY # A
Mailing Address - Street 2:P. O. BOX 2094
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-3271
Mailing Address - Country:US
Mailing Address - Phone:404-378-2232
Mailing Address - Fax:404-378-2239
Practice Address - Street 1:209 SWANTON WAY # A
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-3271
Practice Address - Country:US
Practice Address - Phone:404-378-2232
Practice Address - Fax:404-378-2239
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
GA000870106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty