# COUPLES AT CROSSROADS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689110074
- **Authorized official:** JAKE D THIESSEN PHD (PRESIDENT)
- **Authorized official phone:** (717) 433-5751

## Contact information

- **Practice address:** 525 N 12TH ST, SUITE 100, LEMOYNE, PA 17043-1245
- **Practice address phone:** (717) 743-4223
- **Mailing address:** 525 N 12TH ST, SUITE 100, LEMOYNE, PA 17043-1245
- **Mailing address phone:** (717) 743-4223

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | MF000107 | PA | Yes |

## Other

- **Enumeration date:** 01/10/2017
- **Last updated:** 01/11/2017