Provider Demographics
NPI:1427310390
Name:CROSS, PATRICIA (MS, LMHC, CFRC)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:CROSS
Suffix:
Gender:F
Credentials:MS, LMHC, CFRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 N MAIN ST STE A
Mailing Address - Street 2:
Mailing Address - City:CRESTVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:32536-3506
Mailing Address - Country:US
Mailing Address - Phone:850-238-7131
Mailing Address - Fax:
Practice Address - Street 1:550 N MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:CRESTVIEW
Practice Address - State:FL
Practice Address - Zip Code:32536-3506
Practice Address - Country:US
Practice Address - Phone:850-238-7131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-15
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health