MEDICARE: HEALING CROSSROADS CORPORATION

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1568322485
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALING CROSSROADS CORPORATION

Provider Business Mailing Address
First Line	:	3402 N LECANTO HWY
Second Line	:
City	:	BEVERLY HILLS
State	:	FL
Zip	:	34465-3570
Country	:	US
Telephone Number	:	352-270-8310
Fax Number	:	352-270-8311

Provider Business Practice Location Address
First Line	:	3402 N LECANTO HWY
Second Line	:
City	:	BEVERLY HILLS
State	:	FL
Zip	:	34465-3570
Country	:	US
Telephone Number	:	352-270-8310
Fax Number	:	352-270-8311

Authorized Official
Title or Position	:	OWNER
Name	:	ROBERT LICHTENTHAL
Credential	:	LMHC
Telephone Number	:	352-697-5942

Provider Enumeration Date	:	11/13/2025
Last Update Date	:	11/13/2025

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Directions to “HEALING CROSSROADS CORPORATION ” Practice Location

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