Organization
CROSS CONNECTIONS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW KONOW (EXECUTIVE DIRECTOR)
(260) 373-0213
Entity
Organization
Contact information
Practice address
4618 E STATE BLVD STE 300, FORT WAYNE, IN 46815-6966
(260) 373-0213
(260) 373-0218
Mailing address
4618 E STATE BLVD STE 300, FORT WAYNE, IN 46815-6966
(260) 373-0213
(260) 373-0218
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
104100000X
Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
08/02/2018
Last updated
08/02/2018
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