Healthcare Provider Details

I. General information

NPI: 1902562465
Provider Name (Legal Business Name): CROSSTREES COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2021
Last Update Date: 11/09/2021
Certification Date: 11/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 W PETE ROSE WAY STE 530
CINCINNATI OH
45203-1885
US

IV. Provider business mailing address

700 W PETE ROSE WAY STE 530
CINCINNATI OH
45203-1885
US

V. Phone/Fax

Practice location:
  • Phone: 513-246-4293
  • Fax:
Mailing address:
  • Phone: 513-246-4293
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: ERIC C THOMAS
Title or Position: OWNER, PSYCHOTHERAPIST
Credential: LPCC
Phone: 513-846-5144