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General NPI Number Information
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NPI Number | 1437885100
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Entity Type | Individual
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Provider Name | JUSTIN REID CROSSMAN PHD
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Gender | Male
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Dates
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Enumeration Date | 07/26/2022
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Last Update Date | 04/22/2025
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Provider Practice Location Address
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Address Line | 1675 BENNETT ST
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City | UTICA
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State | NY
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Zip | 13502-5390
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Country | US
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Telephone | 315-525-3228
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Fax |
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Provider Business Mailing Address
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Address Line | 4 GROVE PL APT 3
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City | WHITESBORO
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State | NY
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Zip | 13492-1547
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Country | US
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Telephone | 315-525-3228
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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