Organization
CROSSROADS COUNSELING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. AMANDA ELIZABETH GENTRY LPC (MENTAL HEALTH THERAPIST AND CO-OWNE)
(336) 846-7492
Entity
Organization
Contact information
Practice address
224 N MAIN ST, JEFFERSON, NC 28640-9664
(336) 846-7492
(336) 846-7397
Mailing address
PO BOX 212, JEFFERSON, NC 28640-0212
(336) 846-7492
(336) 846-7397
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
1903
NC
101YM0800X
Mental Health Counselor
3359
NC
101YM0800X
Mental Health Counselor
3369
NC
101YM0800X
Mental Health Counselor
Primary
4955
NC
101YM0800X
Mental Health Counselor
C003481
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
012T0
BLUE CROSS AND BLUE SHIEL
NC
05
—
6005268
—
NC
Enumeration date
03/21/2006
Last updated
08/22/2020
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