Healthcare Provider Details

I. General information

NPI: 1407900525
Provider Name (Legal Business Name): CROSSROADS COUNSELING SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 02/09/2024
Certification Date: 02/09/2024
Deactivation Date: 08/31/2023
Reactivation Date: 10/23/2023

III. Provider practice location address

116 MAIN ST.
BELMONT OH
43718
US

IV. Provider business mailing address

255 W MAIN ST
SAINT CLAIRSVILLE OH
43950-1040
US

V. Phone/Fax

Practice location:
  • Phone: 740-484-4141
  • Fax: 740-484-4143
Mailing address:
  • Phone: 740-695-9447
  • Fax: 740-695-8895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MRS. SHANNAN K WATSON
Title or Position: EXECUTIVE DIRECTOR
Credential: MSW, LSW
Phone: 740-695-9447