Organization Name: | CROSSROADS COUNSELING & CONSULTATION SERVICES, LLC |
NPI Number: | 1922372796 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CANDACE A JOHNSON (THERAPIST/MANAGING MEMBER) |
Mailing Address: | 490 Edward St Middleville |
State: | MI US |
Postal Code: | 493339131 |
Phone Number: | 6164504925 |
Fax Number: | |
NPI Enumeration Date: | 02/27/2012 |
NPI Last Update Date: | 02/27/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 6801082216 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |