Healthcare Provider Details

I. General information

NPI: 1952215451
Provider Name (Legal Business Name): CROSSROADS THERAPY AND WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19850 AL HIGHWAY 75
HENAGAR AL
35978-7459
US

IV. Provider business mailing address

PO BOX 148
HENAGAR AL
35978-0148
US

V. Phone/Fax

Practice location:
  • Phone: 256-717-4011
  • Fax:
Mailing address:
  • Phone: 256-717-4011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code2471S1302X
TaxonomySonography Radiologic Technologist
License Number
License Number StateNULL

VIII. Authorized Official

Name: JUSTIN A LEWIS
Title or Position: OWNER
Credential: MS OTR/L
Phone: 256-717-4011