MEDICARE: THE CROSSROADS CENTER

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)	0315	OH
2	261QM0850X	Adult Mental Health Clinic/Center	0315	OH
3	261QM0855X	Adolescent and Children Mental Health Clinic/Center	0315	OH
4	324500000X	Substance Abuse Rehabilitation Facility	2344	OH
5	320800000X	Mental Illness Community Based Residential Treatment Facility	0315	OH
6	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center	01258	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	01258	OTHER	OH	ODADAS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	0315	OTHER	OH	ODMH
4	31659	OTHER	OH	OHIO DEPT. OF MENTAL HEAL

General Provider Information

NPI Number	:	1265496590
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE CROSSROADS CENTER

Provider Business Mailing Address
First Line	:	311 MARTIN LUTHER KING DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45220-2484
Country	:	US
Telephone Number	:	513-475-5300
Fax Number	:	513-281-1645

Provider Business Practice Location Address
First Line	:	311 MARTIN LUTHER KING DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45220-2484
Country	:	US
Telephone Number	:	513-475-5300
Fax Number	:	513-475-5394

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	MS. JACQUELINE P BUTLER
Credential	:	MSW, LISW
Telephone Number	:	513-475-5300

Provider Enumeration Date	:	04/13/2006
Last Update Date	:	11/05/2008

Similar Medicare Providers

1578495040 — ANDREW YOUNG CHANG OD
Practice Location Address:

2090 FLORENCE AVE
CINCINNATI, OH
45206-2484

Practice Phone: 513-559-3599
Practice Fax:

1669885588 — MOUSSA DEMBA
Practice Location Address:

2484 QUEEN CITY AVE APT 7
CINCINNATI, OH
45238

Practice Phone: 770-695-5962
Practice Fax:

1780072876 — CINCINNATI VAMC
Practice Location Address:

2090 FLORENCE AVE
CINCINNATI, OH
45206-2484

Practice Phone: 608-821-7200
Practice Fax: 608-821-7658

1679339204 — DR. DANIEL COLEMAN PHD
Practice Location Address:

2484 DEERCOVE CT
CINCINNATI, OH
45211-8038

Practice Phone: 614-638-1613
Practice Fax:

1992501761 — TIERRA SHANEE LUNSFORD
Practice Location Address:

2484 CROSLEY MDW
CINCINNATI, OH
45239-3500

Practice Phone: 513-557-0207
Practice Fax:

1225960495 — PETRA TAMIKA ERSKIN DNP, PMHNP-BC
Practice Location Address:

2600 CLIFTON AVE
CINCINNATI, OH
45220-2872

Practice Phone: 513-556-6000
Practice Fax:

Directions to “THE CROSSROADS CENTER ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.