MEDICARE: CROSSROADS COUNSELING & CONSULTING INCORPORATED

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	153LCSW	MT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	284290	OTHER	MT	VALUE OPTIONS
2	70480	OTHER	MT	BLUE CROSS BLUE SHIELD MT
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669594180
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CROSSROADS COUNSELING & CONSULTING INCORPORATED

Provider Business Mailing Address
First Line	:	2 5TH ST N
Second Line	:	SUITE 204
City	:	GREAT FALLS
State	:	MT
Zip	:	59401-4010
Country	:	US
Telephone Number	:	406-727-5046
Fax Number	:	406-727-5047

Provider Business Practice Location Address
First Line	:	2 5TH ST N
Second Line	:	SUITE 204
City	:	GREAT FALLS
State	:	MT
Zip	:	59401-4010
Country	:	US
Telephone Number	:	406-727-5046
Fax Number	:	406-727-5047

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JOSEPH PATRICK BOYLE
Credential	:	LCSW
Telephone Number	:	406-727-5046

Provider Enumeration Date	:	04/04/2007
Last Update Date	:	08/22/2020

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