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General NPI Number Information
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NPI Number | 1669862207
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Entity Type | Organization
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Legal Business Name | CROSSROADS EDUCATION & WELLNESS SERVICES, LLC
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Dates
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Enumeration Date | 02/04/2015
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Last Update Date | 02/04/2015
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Provider Practice Location Address
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Address Line | 1616 H ST NW #106
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City | WASHINGTON
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State | DC
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Zip | 20006-4903
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Country | US
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Telephone | 301-751-5859
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Fax |
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Provider Business Mailing Address
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Address Line | 7711 ANNAPOLIS ROAD PO BOX 425
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City | ODENTON
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State | MD
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Zip | 21113
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Country | US
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Telephone | 301-751-5859
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST / OWNER
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Name | MS. MARKELLE HANDY
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Credential | LPC
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Telephone | 301-751-5859
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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 | PRC14434
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License Number State | DC
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