| Crossing Waters, Pllc | |
|
313 Walnut St Ste 107 Wilmington NC 28401-4063 | |
| (910) 805-8205 | |
| Not Available |
| Full Name | Crossing Waters, Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 313 Walnut St Ste 107, Wilmington, North Carolina |
| Authorized Official Name and Position | Cynthia R Fitzsimmons (CLINICAL PSYCHOLOGIST/OWNER) |
| Authorized Official Contact | 9108058205 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Crossing Waters, Pllc 4602 Manchester Dr Wilmington NC 28405-1317 Ph: (864) 546-0217 | Crossing Waters, Pllc 313 Walnut St Ste 107 Wilmington NC 28401-4063 Ph: (910) 805-8205 |
| NPI Number | 1215549431 |
|---|---|
| Provider Enumeration Date | 08/19/2020 |
| Last Update Date | 08/19/2020 |
| Certification Date | 08/19/2020 |
| Medicare PECOS PAC ID | 6608274840 |
|---|---|
| Medicare Enrollment ID | O20211001002279 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215549431 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Cynthia Fitzsimmons |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1699002089 PECOS PAC ID: 3173650199 Enrollment ID: I20211001002382 |
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