Healthcare Provider Details

I. General information

NPI: 1134291271
Provider Name (Legal Business Name): CROSSROADS COUNSELING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 S BROADWAY ST
STANLEY WI
54768-1011
US

IV. Provider business mailing address

224 S BROADWAY ST
STANLEY WI
54768-1011
US

V. Phone/Fax

Practice location:
  • Phone: 715-644-4357
  • Fax: 715-644-5053
Mailing address:
  • Phone: 715-644-4357
  • Fax: 715-644-5053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number2219
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2219
License Number StateWI

VIII. Authorized Official

Name: KAREN J KOLTIS
Title or Position: OWNER AND DIRECTOR
Credential: MS,LPC,LMFT,CADC
Phone: 715-644-4357