MEDICARE: CROSSROADS THERAPY COLLABORATIVE PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1265389225
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CROSSROADS THERAPY COLLABORATIVE PLLC

Provider Business Mailing Address
First Line	:	24518 62ND AVE
Second Line	:
City	:	LITTLE NECK
State	:	NY
Zip	:	11362-2052
Country	:	US
Telephone Number	:	516-424-0886
Fax Number	:

Provider Business Practice Location Address
First Line	:	24518 62ND AVE
Second Line	:
City	:	LITTLE NECK
State	:	NY
Zip	:	11362-2052
Country	:	US
Telephone Number	:	516-424-0886
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SARA ELIZABETH MUSACCHIA
Credential	:	LCSW
Telephone Number	:	516-424-0886

Provider Enumeration Date	:	03/11/2026
Last Update Date	:	03/11/2026

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