Healthcare Provider Details

I. General information

NPI: 1497687883
Provider Name (Legal Business Name): CROSSROADS COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 WILLOW SPGS
NEW MILFORD CT
06776-4367
US

IV. Provider business mailing address

240 WILLOW SPGS
NEW MILFORD CT
06776-4367
US

V. Phone/Fax

Practice location:
  • Phone: 203-917-8601
  • Fax: 203-917-8601
Mailing address:
  • Phone: 203-917-8601
  • Fax: 203-917-8601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: YVONNE MORA
Title or Position: MENTAL HEALTH CLINICIAN
Credential: LPC
Phone: 203-917-8601