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General NPI Number Information
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NPI Number | 1679642672
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Entity Type | Organization
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Legal Business Name | CROSSROADS THERAPY LLC
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 16950 19 MILE RD SUITE 3A
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City | CLINTON TWP
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State | MI
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Zip | 48038
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Country | US
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Telephone | 586-226-1991
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Fax | 586-286-1138
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Provider Business Mailing Address
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Address Line | PO BOX 380452
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City | CLINTON TWP
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State | MI
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Zip | 48038-0065
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Country | US
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Telephone | 586-226-1991
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Fax | 586-286-1138
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Authorized Official
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Title or Position | OWNER OPERATOR
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Name | MR. MARK F WARCHOL
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Credential | LMSW LMFT
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Telephone | 586-226-1991
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 6801060259
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 4101006085
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License Number State | MI
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