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General NPI Number Information
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NPI Number | 1568322485
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Entity Type | Organization
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Legal Business Name | HEALING CROSSROADS CORPORATION
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Dates
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Enumeration Date | 11/13/2025
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Last Update Date | 11/13/2025
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Provider Practice Location Address
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Address Line | 3402 N LECANTO HWY
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City | BEVERLY HILLS
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State | FL
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Zip | 34465-3570
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Country | US
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Telephone | 352-270-8310
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Fax | 352-270-8311
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Provider Business Mailing Address
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Address Line | 3402 N LECANTO HWY
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City | BEVERLY HILLS
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State | FL
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Zip | 34465-3570
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Country | US
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Telephone | 352-270-8310
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Fax | 352-270-8311
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Authorized Official
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Title or Position | OWNER
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Name | ROBERT LICHTENTHAL
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Credential | LMHC
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Telephone | 352-697-5942
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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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