| Crossroads Counseling Centers, Inc. | |
|
214 4th St Sw Willmar MN 56201-3330 | |
| (320) 214-8558 | |
| (320) 235-2733 |
| Full Name | Crossroads Counseling Centers, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 214 4th St Sw, Willmar, Minnesota |
| Authorized Official Name and Position | Daniel Scott Nelson (OWNER/DIRECTOR) |
| Authorized Official Contact | 3202148558 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Crossroads Counseling Centers, Inc. 214 4th St Sw Willmar MN 56201-3330 Ph: (320) 214-8558 | Crossroads Counseling Centers, Inc. 214 4th St Sw Willmar MN 56201-3330 Ph: (320) 214-8558 |
| NPI Number | 1437160264 |
|---|---|
| Provider Enumeration Date | 08/10/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 5193728517 |
|---|---|
| Medicare Enrollment ID | O20060824000101 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437160264 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Kathryn A Lichty |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477830263 PECOS PAC ID: 1153588827 Enrollment ID: I20120208000217 |
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