CROSSROADS COGNITIVE BEHAVIORAL SERVICES (NPI# 1598215980) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598215980 |
| Entity Type | Organization |
| Organization Name | CROSSROADS COGNITIVE BEHAVIORAL SERVICES |
| Practice Address |
2454 W Lisbon Ave Milwaukee WI 53205-1413 |
| Practice Telephone | 4145626361 |
| Practice Fax Number | 4142048689 |
| Mailing Telephone | 4145626361 |
| Mailing Fax Number | 4142048689 |
| Enumeration Date | 2016-10-10 |
| Last Update Date | 2016-10-10 |
| Authorized Official Name | MR. DERECK MCCLENDON (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 4145626361 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | WI | Agencies |
| Street Address |
2454 W LISBON AVE |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53205-1413 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699224584 | Dereck Mcclendon | Counselor | 2454 W Lisbon Ave, Milwaukee, WI 53205-1413 | 2016-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467931691 | The Salvation Army - Wisconsin and Upper Michigan | Counselor | 1730 N 7th Street, Milwaukee, WI 53205 | 2018-08-08 |
| 1821596909 | Robert Leland Goodman | Counselor | 1134 W. North Ave, Second Floor, Milwaukee, WI 53205 | 2018-01-24 |
| 1265980767 | Wisconsin Healthcare Services | Clinic/Center | 2462 West Lisbon Avenue, Milwaukee, WI 53205 | 2016-09-14 |
| 1841667466 | St. Ann Center for Intergenerational Care | Public Health or Welfare | 2450 W North Ave, Milwaukee, WI 53205 | 2015-08-31 |
| 1407252646 | Abdelrahman H. Alarga | Pharmacist | 1919 W North Ave., Milwaukee, WI 53205 | 2014-11-17 |
| 1679981328 | Life Changing Ministries Substance Abuse Services | Clinic/Center | 1134 W North Ave 2nd Floor, Milwaukee, WI 53205 | 2014-07-25 |
| 1891031969 | Robin Michelle Benjamin | Licensed Practical Nurse | 1536 N 20th, Mil., WI 53205 | 2012-12-18 |
| 1275712937 | Bruce G Hartwell | Dentist | 901 W Winnebago St, Suite Ll-01, Milwaukee, WI 53205 | 2007-10-30 |
| 1407978521 | Westside Healthcare Association, Inc | Clinic/Center | 1452 N. 7th Street, Milwaukee, WI 53205 | 2007-04-06 |
| 1740316181 | Neville Winston Duncan | Family Medicine | 1134 W North Ave Fl 2, Milwaukee, WI 53205 | 2007-02-27 |
| Find all providers in zip 53205 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558968990 | Zoran Jovicic | Community/Behavioral Health | 3239 S 58th St Unit 104, Milwaukee, WI 53219-4365 | 2020-10-08 |
| 1548816580 | Latara Williams | Community/Behavioral Health | 2447 N 50th St, Milwaukee, WI 53210-2815 | 2019-08-15 |
| 1942856091 | Kennedy's Circle of Wellness LLC | Community/Behavioral Health | 3614 W North Ave, Milwaukee, WI 53208-1416 | 2019-08-14 |
| 1205391828 | Jerome Pitchford | Community/Behavioral Health | 1220 W Atkinson Ave, Milwaukee, WI 53206-3024 | 2019-02-07 |
| 1194233718 | The Evolving Chair Counseling and Consulting Agency | Community/Behavioral Health | 3100 N 78th St, Milwaukee, WI 53222-3916 | 2018-01-17 |
| 1316453905 | D.a.a.n.i Professional Counseling Service LLC | Community/Behavioral Health | 2943 N 52nd St, Milwaukee, WI 53210-1610 | 2017-12-19 |
| 1932654845 | The Thresholds | Community/Behavioral Health | 6815 W Capitol Dr # 305, Milwaukee, WI 53216-2070 | 2016-08-20 |
| 1801341144 | Fly Philanthropy Inc | Community/Behavioral Health | 3352 N Palmer St, Milwaukee, WI 53212-1541 | 2016-08-16 |
| 1659726545 | Pathway Youth & Famiy Services | Community/Behavioral Health | 3879 N Port Washington Rd, Milwaukee, WI 53212-1180 | 2016-04-27 |
| 1528413671 | Adventures In Play, LLC | Community/Behavioral Health | 2118 E Kenilworth Pl, Lowr, Milwaukee, WI 53202-1327 | 2016-04-26 |
| Find all providers in MILWAUKEE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.