Provider Demographics
NPI:1952085490
Name:CROSS BEHAVIORAL CONSULTING LLC
Entity Type:Organization
Organization Name:CROSS BEHAVIORAL CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EBONY
Authorized Official - Middle Name:JOI
Authorized Official - Last Name:CROSS
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:301-374-8772
Mailing Address - Street 1:2670 CRAIN HWY STE 510
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20601-2819
Mailing Address - Country:US
Mailing Address - Phone:301-374-8772
Mailing Address - Fax:301-374-8773
Practice Address - Street 1:2670 CRAIN HWY STE 510
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20601-2819
Practice Address - Country:US
Practice Address - Phone:301-374-8772
Practice Address - Fax:301-374-8773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health