| The Crossroads Center | |
|
311 Martin Luther King Dr Cincinnati OH 45220-2484 | |
| (513) 475-5300 | |
| (513) 475-5394 |
| Full Name | The Crossroads Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 311 Martin Luther King Dr, Cincinnati, Ohio |
| Authorized Official Name and Position | Jacqueline P Butler (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 5134755300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Crossroads Center 311 Martin Luther King Dr Cincinnati OH 45220-2484 Ph: (513) 475-5300 | The Crossroads Center 311 Martin Luther King Dr Cincinnati OH 45220-2484 Ph: (513) 475-5300 |
| NPI Number | 1265496590 |
|---|---|
| Provider Enumeration Date | 04/13/2006 |
| Last Update Date | 11/05/2008 |
| Medicare PECOS PAC ID | 4284057746 |
|---|---|
| Medicare Enrollment ID | O20200813002153 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265496590 | NPI | - | NPPES |
| 01258 | Other | OH | ODADAS |
| 93.778 | Medicaid | OH | |
| 0315 | Other | OH | ODMH |
| 31659 | Other | OH | OHIO DEPT. OF MENTAL HEAL |
| Provider Name | Roberto R Soria |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417020819 PECOS PAC ID: 2365462843 Enrollment ID: I20051129000594 |
| Provider Name | Karen Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346449642 PECOS PAC ID: 7012050982 Enrollment ID: I20100202000096 |
| Provider Name | Daniyel Roper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457788820 PECOS PAC ID: 1456680321 Enrollment ID: I20190903002070 |
| Provider Name | Joshua J Oglehart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811338999 PECOS PAC ID: 0648408229 Enrollment ID: I20200924001550 |
| Provider Name | Kevin M Drummond |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801541214 PECOS PAC ID: 4082078308 Enrollment ID: I20230919003282 |
| Provider Name | Toni Deniese Mason |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245834738 PECOS PAC ID: 4082068317 Enrollment ID: I20230920003092 |
| Provider Name | Abimbola Bridget Olaore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528328093 PECOS PAC ID: 2769573617 Enrollment ID: I20231211003232 |
| Provider Name | Tadesse M Bantirgu |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1093179897 PECOS PAC ID: 0840633459 Enrollment ID: I20240212001104 |
| Provider Name | Michelle Velta Spangenberg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417440132 PECOS PAC ID: 0749624021 Enrollment ID: I20240214002252 |
| Provider Name | Shirley Ann Middleton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1497118863 PECOS PAC ID: 0840634119 Enrollment ID: I20240215000865 |
| Provider Name | Ann Burlew |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1417310103 PECOS PAC ID: 9830533058 Enrollment ID: I20240215002849 |
| Provider Name | Bernard Paul Gray |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1831553965 PECOS PAC ID: 2769826718 Enrollment ID: I20240216003891 |
| Provider Name | Patricia Brown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003081720 PECOS PAC ID: 8527412634 Enrollment ID: I20240403001947 |
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