Provider Demographics
NPI:1609199322
Name:CROSSROADS COUNSELING, INC
Entity type:Organization
Organization Name:CROSSROADS COUNSELING, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BILL
Authorized Official - Middle Name:
Authorized Official - Last Name:KNECHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-323-7535
Mailing Address - Street 1:444 E COLLEGE AVE
Mailing Address - Street 2:SUITE 460
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-5558
Mailing Address - Country:US
Mailing Address - Phone:814-231-0940
Mailing Address - Fax:
Practice Address - Street 1:444 E COLLEGE AVE
Practice Address - Street 2:SUITE 460
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-5558
Practice Address - Country:US
Practice Address - Phone:814-231-0940
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-09
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA101YA0400X
PA147021251K00000X, 251S00000X, 261Q00000X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No251K00000XAgenciesPublic Health or Welfare
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007434200012Medicaid
PA1007434200010Medicaid
PA1007434200014Medicaid