Provider Demographics
NPI:1871365130
Name:CROSSPOINT MENTAL HEALTH THERAPY
Entity type:Organization
Organization Name:CROSSPOINT MENTAL HEALTH THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MOATES
Authorized Official - Suffix:
Authorized Official - Credentials:EDD, LP, LBA, LMHC
Authorized Official - Phone:817-934-9500
Mailing Address - Street 1:5764 N ORANGE BLOSSOM TRL PMB 61546
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32810
Mailing Address - Country:US
Mailing Address - Phone:817-934-9500
Mailing Address - Fax:888-329-2764
Practice Address - Street 1:1350 N BLUE MOUND ROAD, #2101
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:TX
Practice Address - Zip Code:76131
Practice Address - Country:US
Practice Address - Phone:817-934-9500
Practice Address - Fax:888-329-2764
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty