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General NPI Number Information
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NPI Number | 1417151689
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Entity Type | Organization
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Legal Business Name | CROSSROADS PSYCHOLOGICAL ASSOCIATES
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Dates
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Enumeration Date | 06/12/2007
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Last Update Date | 11/17/2021
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Provider Practice Location Address
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Address Line | CROSSROADS PSYCHOLOGICAL ASSOCIATES 170 AVE. AT THE COMMON, SUITE 8A
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City | SHREWSBURY
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State | NJ
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Zip | 07702-4595
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Country | US
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Telephone | 732-542-8043
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Fax |
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Provider Business Mailing Address
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Address Line | CROSSROADS PSYCHOLOGICAL ASSOCIATES 170 AVE. AT THE COMMON, SUITE 8A
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City | SHREWSBURY
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State | NJ
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Zip | 07702-4595
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Country | US
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Telephone | 732-542-8043
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. SHERRY J. RILEY
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Credential |
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Telephone | 732-542-8043
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | #1691
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | #3403
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | #2539
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License Number State | NJ
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