| Crossover Counseling | |
|
3524 Ne Stallings Dr Nacogdoches TX 75965-8728 | |
| (936) 560-6855 | |
| (936) 564-5232 |
| Full Name | Crossover Counseling |
|---|---|
| Speciality | Counselor |
| Location | 3524 Ne Stallings Dr, Nacogdoches, Texas |
| Authorized Official Name and Position | Laura L Smith (LICENSED PROFESSIONAL COUNSELOR) |
| Authorized Official Contact | 9365606855 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Crossover Counseling 3524 Ne Stallings Dr Nacogdoches TX 75965-8728 Ph: (936) 560-6855 | Crossover Counseling 3524 Ne Stallings Dr Nacogdoches TX 75965-8728 Ph: (936) 560-6855 |
| NPI Number | 1952506651 |
|---|---|
| Provider Enumeration Date | 06/20/2007 |
| Last Update Date | 03/03/2023 |
| Certification Date | 03/03/2023 |
| Medicare PECOS PAC ID | 6204112493 |
|---|---|
| Medicare Enrollment ID | O20170425001354 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952506651 | NPI | - | NPPES |
| 163087301 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 13439 (Texas) | Primary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| Provider Name | Maura C Messer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215576277 PECOS PAC ID: 0840682381 Enrollment ID: I20220113001447 |
| Provider Name | Linda R Millican |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1750879557 PECOS PAC ID: 9931548252 Enrollment ID: I20240419001464 |
| Provider Name | Susan L Moore |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1467178020 PECOS PAC ID: 9436692720 Enrollment ID: I20240614001212 |
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