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General NPI Number Information
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NPI Number | 1407329469
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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 | 01/02/2019
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Last Update Date | 01/31/2025
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Provider Practice Location Address
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Address Line | 843 N WASHINGTON AVE
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City | EMMETT
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State | ID
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Zip | 83617-5076
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Country | US
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Telephone | 208-365-3141
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Fax | 208-398-8311
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Provider Business Mailing Address
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Address Line | 843 N WASHINGTON AVE
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City | EMMETT
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State | ID
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Zip | 83617-5076
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Country | US
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Telephone | 208-365-3141
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Fax | 208-398-8311
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Authorized Official
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Title or Position | OWNER
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Name | JILL J SPRAGUE
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Credential | MA, LCPC
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Telephone | 208-365-3141
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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 | 175T00000X
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Taxonomy Name | Peer Specialist
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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