Healthcare Provider Details

I. General information

NPI: 1114155900
Provider Name (Legal Business Name): CROSSINGS HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2009
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

412 HIGHTOWER RD
GIRDWOOD AK
99587
US

IV. Provider business mailing address

PO BOX 1132
GIRDWOOD AK
99587-1132
US

V. Phone/Fax

Practice location:
  • Phone: 502-494-8249
  • Fax:
Mailing address:
  • Phone: 502-494-8249
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number716
License Number StateKY

VIII. Authorized Official

Name: JODIE R MENISH
Title or Position: DIRECTOR
Credential: LCSW
Phone: 502-494-8249