Provider Demographics
NPI:1174947014
Name:CROSSWALK BEHAVIORAL HEALTH INC.
Entity type:Organization
Organization Name:CROSSWALK BEHAVIORAL HEALTH INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:G
Authorized Official - Last Name:CHARPENTIER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMHC
Authorized Official - Phone:978-668-5099
Mailing Address - Street 1:PO BOX 245
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01473-0245
Mailing Address - Country:US
Mailing Address - Phone:978-668-5099
Mailing Address - Fax:978-668-5092
Practice Address - Street 1:71 MAIN ST
Practice Address - Street 2:SUITE 2C
Practice Address - City:WESTMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01473-1472
Practice Address - Country:US
Practice Address - Phone:978-668-5099
Practice Address - Fax:978-668-5092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-12
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4847103TC0700X
MA8473101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty