Healthcare Provider Details

I. General information

NPI: 1043106933
Provider Name (Legal Business Name): CROSSROADS COUNSELING SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2025
Last Update Date: 06/19/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13550 S ROUTE 30 STE 302
PLAINFIELD IL
60544-5688
US

IV. Provider business mailing address

1802 N DIVISION ST STE 509
MORRIS IL
60450-3107
US

V. Phone/Fax

Practice location:
  • Phone: 815-941-3882
  • Fax: 815-941-3884
Mailing address:
  • Phone: 181-579-1787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANGELA SOLIS
Title or Position: OWNER/THERAPIST
Credential:
Phone: 815-941-3882