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General NPI Number Information
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NPI Number | 1174718159
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Entity Type | Organization
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Legal Business Name | CROSSROADS COUNSELIING & COUNSULTATION
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Dates
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Enumeration Date | 09/12/2007
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Last Update Date | 09/12/2007
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Provider Practice Location Address
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Address Line | 9717 E 42ND ST SUITE 208
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City | TULSA
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State | OK
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Zip | 74146-3618
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Country | US
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Telephone | 918-270-4100
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Fax |
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Provider Business Mailing Address
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Address Line | 9717 E 42ND ST SUITE 208
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City | TULSA
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State | OK
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Zip | 74146-3618
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Country | US
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Telephone | 918-270-4100
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | MR. ROBERT CHARLES WARWICK JR.
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Credential |
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Telephone | 918-270-4100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 1953
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License Number State | OK
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