Healthcare Provider Details
I. General information
NPI: 1588873459
Provider Name (Legal Business Name): POTOMAC CROSSROADS COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/21/2007
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4781 KEARNEYSVILLE PIKE
SHEPHERDSTOWN WV
25443-4666
US
IV. Provider business mailing address
PO BOX 192
SHEPHERDSTOWN WV
25443-0192
US
V. Phone/Fax
- Phone: 304-876-3500
- Fax:
- Phone: 304-876-2770
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KATHLEEN
MOROTTI
Title or Position: OWNER
Credential: LPC, LCDAC, ADTR
Phone: 304-876-2770