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General NPI Number Information
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NPI Number | 1043304892
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Entity Type | Organization
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Legal Business Name | CROSSROADS COUNSELING, INC.
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 01/20/2020
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Provider Practice Location Address
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Address Line | 501 EAST THIRD STREET
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City | WILLIAMSPORT
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State | PA
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Zip | 17701
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Country | US
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Telephone | 570-323-7535
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Fax | 570-323-3790
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Provider Business Mailing Address
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Address Line | 501 EAST THIRD STREET
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City | WILLIAMSPORT
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State | PA
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Zip | 17701
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Country | US
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Telephone | 570-323-7535
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Fax | 570-323-3790
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Authorized Official
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Title or Position | DIRECTOR
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Name | WILLIAM E KNECHT
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Credential |
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Telephone | 570-323-7535
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 417017
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 417017
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | 417017
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License Number State | PA
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Taxonomy #5
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 417017
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License Number State | PA
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