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General NPI Number Information
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NPI Number | 1215133616
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Entity Type | Organization
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Legal Business Name | CROSSROADS COUNSELING ASSOC.
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Dates
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Enumeration Date | 06/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4131 SPICEWOOD SPRINGS RD BLDG. K #1
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City | AUSTIN
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State | TX
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Zip | 78759-8661
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Country | US
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Telephone | 512-346-9299
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Fax |
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Provider Business Mailing Address
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Address Line | 4131 SPICEWOOD SPRINGS RD BLDG. K #1
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City | AUSTIN
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State | TX
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Zip | 78759-8661
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Country | US
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Telephone | 512-346-9299
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RICK REYNOLDS
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Credential | LCSW
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Telephone | 512-346-9299
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 18290
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License Number State | TX
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