| Cross Roads Professional Counseling | |
|
3362 Primrose Ln Ypsilanti MI 48197-3216 | |
| (734) 649-8263 | |
| (734) 619-6554 |
| Full Name | Cross Roads Professional Counseling |
|---|---|
| Speciality | Counselor |
| Location | 3362 Primrose Ln, Ypsilanti, Michigan |
| Authorized Official Name and Position | Tabrina La Shawn Dixon (CEO/LPC/MENTAL HEALTH THERAPIST) |
| Authorized Official Contact | 7346498263 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cross Roads Professional Counseling Po Box 972843 Ypsilanti MI 48197-0323 Ph: (734) 649-8263 | Cross Roads Professional Counseling 3362 Primrose Ln Ypsilanti MI 48197-3216 Ph: (734) 649-8263 |
| NPI Number | 1962716308 |
|---|---|
| Provider Enumeration Date | 07/27/2010 |
| Last Update Date | 12/08/2023 |
| Certification Date | 12/08/2023 |
| Medicare PECOS PAC ID | 3577912757 |
|---|---|
| Medicare Enrollment ID | O20231213001858 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962716308 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 6401007811 (Michigan) | Primary |
| Provider Name | Tabrina La Shawn Dixon |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376741777 PECOS PAC ID: 4486003662 Enrollment ID: I20231213002021 |
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