MEDICARE: CROSS BEHAVIORAL CONSULTING

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101YP2500X	Professional Counselor
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner
3	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972160406
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CROSS BEHAVIORAL CONSULTING

Provider Business Mailing Address
First Line	:	2670 CRAIN HWY STE 510
Second Line	:
City	:	WALDORF
State	:	MD
Zip	:	20601-2819
Country	:	US
Telephone Number	:	301-374-8772
Fax Number	:	301-374-8773

Provider Business Practice Location Address
First Line	:	2670 CRAIN HWY STE 510
Second Line	:
City	:	WALDORF
State	:	MD
Zip	:	20601-2819
Country	:	US
Telephone Number	:	301-374-8772
Fax Number	:	301-374-8773

Authorized Official
Title or Position	:	PSYCHIATRIC NURSE PRACTITIONER
Name	:	MS. EBONY JOI CROSS
Credential	:	CRNP-PMH
Telephone Number	:	919-408-4627

Provider Enumeration Date	:	05/21/2019
Last Update Date	:	02/09/2024

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Directions to “CROSS BEHAVIORAL CONSULTING ” Practice Location

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