Provider Demographics
NPI:1447084801
Name:CROSS COUNSELING
Entity type:Organization
Organization Name:CROSS COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSE PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:CROSS
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:810-922-6313
Mailing Address - Street 1:3071 N HENDERSON RD
Mailing Address - Street 2:
Mailing Address - City:DAVISON
Mailing Address - State:MI
Mailing Address - Zip Code:48423-8113
Mailing Address - Country:US
Mailing Address - Phone:810-922-6313
Mailing Address - Fax:
Practice Address - Street 1:3000 LEONARD ST NE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49525-5831
Practice Address - Country:US
Practice Address - Phone:810-922-6313
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-28
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty