Organization
CROSSROADS COUNSELING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARCELLA DAWN FLEETWOOD PLPC (OFFICE MANAGER)
(417) 926-7623
Entity
Organization
Contact information
Practice address
600 N MAIN ST, MOUNTAIN GROVE, MO 65711-1309
(417) 926-7623
Mailing address
600 N MAIN ST, MOUNTAIN GROVE, MO 65711-1309
(417) 926-7623
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1982973236
—
MO
Enumeration date
11/05/2012
Last updated
11/05/2012
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