Provider Demographics
NPI:1992573463
Name:CROSSROADS COUNSELING CENTER, PLLC
Entity type:Organization
Organization Name:CROSSROADS COUNSELING CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:SWANSON
Authorized Official - Last Name:LEDWIG
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:361-648-5207
Mailing Address - Street 1:5803 JOHN STOCKBAUER DR STE M
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77904-3506
Mailing Address - Country:US
Mailing Address - Phone:361-648-5207
Mailing Address - Fax:346-395-5110
Practice Address - Street 1:5803 JOHN STOCKBAUER DR STE M
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77904-3506
Practice Address - Country:US
Practice Address - Phone:361-648-5207
Practice Address - Fax:346-395-5110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-14
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty