Healthcare Provider Details

I. General information

NPI: 1417887258
Provider Name (Legal Business Name): CROSSROADS BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6545 MARKET AVE N STE 100
CANTON OH
44721-2430
US

IV. Provider business mailing address

6065 DARBY LN
COLUMBUS OH
43229-2626
US

V. Phone/Fax

Practice location:
  • Phone: 380-277-3887
  • Fax:
Mailing address:
  • Phone: 313-746-8297
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: MS. SUSAN LYNN OBRIEN
Title or Position: COUNSELOR
Credential: LPCC
Phone: 313-746-8297