CROSSOVER OUTPATIENT SERVICES LLC (NPI# 1891217600) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891217600 |
| Entity Type | Organization |
| Organization Name | CROSSOVER OUTPATIENT SERVICES LLC |
| Practice Address |
241 Lemon St Ne Ste C Marietta GA 30060-1644 |
| Mailing Address |
227 Sandy Springs Pl Ste D-298 Sandy Springs GA 30328-5918 |
| Practice Telephone | 4044001989 |
| Mailing Telephone | 4044001989 |
| Enumeration Date | 2017-07-13 |
| Last Update Date | 2018-04-19 |
| Authorized Official Name | MR. JOHN CRAIG BREMNER (OWNER) |
| Authorized Official Telephone | 7706397100 |
| Authorized Official Credential | CACII, CCS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
GA | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 576 Woodruff Road, Suited, Greenville, SC 29607 | 7706397100 |
| Street Address |
241 LEMON ST NE STE C |
| City | MARIETTA |
| State | GA |
| Zip Code | 30060-1644 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144845116 | Legacy Center for Spinal Surgery, LLC | Neurological Surgery | 1900 The Exchange, Ne, Suite 600, Marietta, GA 30060 | 2020-06-15 |
| 1407477193 | Michael Cynil Daniel | Counselor | 698 N Marietta, Pkwy, Marietta, GA 30060 | 2020-05-04 |
| 1285253401 | Cameron Thomas Kennelly | Student in an Organized Health Care Education/Training Program | 677 Church Street Ne Attn:gme, Marietta, GA 30060 | 2020-04-09 |
| 1922640739 | Jeremiah George Blair | Physician Assistant | 61 Whitcher St Suite 2100, Marietta, GA 30060 | 2019-10-14 |
| 1164064945 | Denise Alicia Mick | Registered Nurse | 677 Church St Wellstar Kennestone Hospital, Marietta, GA 30060 | 2019-10-12 |
| 1184283772 | Iora Health Georgia, P.C. | Internal Medicine | 280 Cobb Pkwy Se, Suite 60, Marietta, GA 30060 | 2019-06-07 |
| 1346703212 | Caitlin Virginia Mueller | Student in an Organized Health Care Education/Training Program | 677 Church Street Ne, Attn: Gme, Marietta, GA 30060 | 2019-04-08 |
| 1184187205 | Adero Francis | Student in an Organized Health Care Education/Training Program | Wellstar Kennestone Gme Internal Medicine Clinic, 833 Campbell Hill St Nw, Suite 250, Marietta, GA 30060 | 2019-04-08 |
| 1659832749 | Matthew Mozzo | Student in an Organized Health Care Education/Training Program | 677 Church Street / Lower Level, Gme Department / I.m., Marietta, GA 30060 | 2019-03-29 |
| 1245797430 | La'myia Spentz | Specialist | 109 Anderson St Ne, Suite 608, Marietta, GA 30060 | 2019-02-25 |
| Find all providers in zip 30060 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477194371 | Dana Rene Forshey | Counselor | 1165 Lynch Church Rd, Marietta, OH 45750-7530 | 2019-10-01 |
| 1811540123 | Ashley Baker | Counselor | 1417 Lancaster St, Marietta, OH 45750-7973 | 2019-07-17 |
| 1811485550 | Berneice Harris | Counselor | 120 S Park Sq Ne Ste 205, Marietta, GA 30060-8632 | 2018-04-27 |
| 1598279754 | Marc V Pimsler | Counselor | 2621 Sandy Plains Rd Ste 101, Marietta, GA 30066-4276 | 2017-11-27 |
| 1033646864 | Aminta Osejo | Counselor | 1368 Atlanta Rd Se Ste 111, Marietta, GA 30060-3936 | 2017-05-11 |
| 1144755752 | Kawonda Holland | Counselor | 2117 Caswell Cir, Marietta, GA 30060-9262 | 2017-04-21 |
| 1164965752 | Jennifer Ann Simmons | Counselor | 121 Putnam St, Marietta, OH 45750 | 2016-11-30 |
| 1811449010 | Kaylee Rebecca-ann Weihl | Counselor | 207 D Colegate Drive, Marietta, OH 45750 | 2016-11-04 |
| 1336518620 | Courtney Stires | Counselor | 1338 Colegate Dr Ste B, Marietta, OH 45750-1329 | 2015-09-17 |
| 1699172684 | Kim L Roberts | Counselor | 1801 Baldwin Farms Dr, Marietta, GA 30068-1555 | 2014-11-19 |
| Find all providers in MARIETTA | ||||
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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.