Healthcare Provider Details

I. General information

NPI: 1801726575
Provider Name (Legal Business Name): CROSSWAY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

732 RACETRACK RD
MCDONOUGH GA
30252-6843
US

IV. Provider business mailing address

732 RACETRACK RD
MCDONOUGH GA
30252-6843
US

V. Phone/Fax

Practice location:
  • Phone: 678-782-7718
  • Fax:
Mailing address:
  • Phone: 678-782-7718
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. PAMELA GAIL MCMICHEN
Title or Position: CEO/ CLINICAL DIRECTOR
Credential: EDS, LPC, CPCS
Phone: 678-782-7718