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General NPI Number Information
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NPI Number | 1376156471
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Entity Type | Organization
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Legal Business Name | CROSS COUNSELING AND COACHING, INC.
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Dates
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Enumeration Date | 08/28/2020
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Last Update Date | 08/28/2020
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Provider Practice Location Address
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Address Line | 7 BRONZE POINTE S STE B2
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City | SWANSEA
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State | IL
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Zip | 62226-8308
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Country | US
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Telephone | 618-207-2547
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Fax |
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Provider Business Mailing Address
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Address Line | 7 BRONZE POINTE S STE B2
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City | SWANSEA
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State | IL
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Zip | 62226-8308
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Country | US
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Telephone | 618-207-2547
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Fax |
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Authorized Official
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Title or Position | CLINIC DIRECTOR
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Name | JOCELYN R. CROSS
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Credential | LCSW
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Telephone | 618-207-2547
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 163WP0807X
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Taxonomy Name | Child & Adolescent Psychiatric/Mental Health Registered Nurse
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License Number |
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License Number State |
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