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Organization
ROOTS AT CROSSROADS COUNSELING LLC
Active
Organization
ROOTS AT CROSSROADS COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SEVIL H MODESTE LCSW, LCADC (CEO)
(908) 798-4809
Entity
Organization
Contact information
Practice address
2040 MILLBURN AVE STE 102, MAPLEWOOD, NJ 07040-3716
(908) 798-4809
Mailing address
2040 MILLBURN AVE STE 102, MAPLEWOOD, NJ 07040-3716
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
02/08/2022
Last updated
09/09/2022
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