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General NPI Number Information
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NPI Number | 1003347287
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Entity Type | Organization
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Legal Business Name | CROSSROADS COUNSELING
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Dates
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Enumeration Date | 03/21/2017
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Last Update Date | 03/21/2017
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Provider Practice Location Address
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Address Line | 801 LIGHTHOUSE AVE 212
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City | MONTEREY
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State | CA
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Zip | 93940-1046
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Country | US
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Telephone | 831-240-8728
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Fax |
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Provider Business Mailing Address
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Address Line | 801 LIGHTHOUSE AVE 212
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City | MONTEREY
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State | CA
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Zip | 93940-1046
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Country | US
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Telephone | 831-240-8728
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. MIRYAM NOEMI MEJIA
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Credential | LMFT
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Telephone | 831-240-8728
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 51905
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License Number State | CA
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