| Crossroads Counseling Services, Inc. | |
|
409 W New Circle Rd Lexington KY 40511-1832 | |
| (859) 800-5353 | |
| (859) 554-0408 |
| Full Name | Crossroads Counseling Services, Inc. |
|---|---|
| Speciality | Counselor |
| Location | 409 W New Circle Rd, Lexington, Kentucky |
| Authorized Official Name and Position | David Waters (CEO) |
| Authorized Official Contact | 5023707229 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Crossroads Counseling Services, Inc. 1236 Paris Pike Georgetown KY 40324-9701 Ph: () - | Crossroads Counseling Services, Inc. 409 W New Circle Rd Lexington KY 40511-1832 Ph: (859) 800-5353 |
| NPI Number | 1962931972 |
|---|---|
| Provider Enumeration Date | 06/05/2017 |
| Last Update Date | 11/15/2023 |
| Certification Date | 11/15/2023 |
| Medicare PECOS PAC ID | 5597102566 |
|---|---|
| Medicare Enrollment ID | O20240326002861 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962931972 | NPI | - | NPPES |
| 7100587310 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | David Waters |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427400977 PECOS PAC ID: 5193158855 Enrollment ID: I20191210003330 |
| Provider Name | Denise R Myers |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457015851 PECOS PAC ID: 1456791276 Enrollment ID: I20240426002335 |
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