Provider Demographics
NPI:1174718159
Name:CROSSROADS COUNSELIING & COUNSULTATION
Entity type:Organization
Organization Name:CROSSROADS COUNSELIING & COUNSULTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:WARWICK
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:918-270-4100
Mailing Address - Street 1:9717 E 42ND ST
Mailing Address - Street 2:SUITE 208
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74146-3618
Mailing Address - Country:US
Mailing Address - Phone:918-270-4100
Mailing Address - Fax:
Practice Address - Street 1:9717 E 42ND ST
Practice Address - Street 2:SUITE 208
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74146-3618
Practice Address - Country:US
Practice Address - Phone:918-270-4100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-12
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK19531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty