NPIMap

Organization Active NPI

Crossroads Addiction & Mental Health Services, Inc.

  • Community/Behavioral Health Agency
  • South Sioux City, NE
National Provider Identifier
1003256082
Registry record updated Dec 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
569 Issued in NE
Legal business name
CROSSROADS ADDICTION & MENTAL HEALTH SERVICES, INC.
Practice address
1000 W 29TH St
Suite 320
South Sioux City, NE 68776-3852
Phone
(712) 574-4357
NPI assigned
Jul 5, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Stephanie Ann Jensen, PH.DNPI 1871760355
Title
President/Owner
Phone
(712) 301-4518

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 569 NE Primary
Community/Behavioral Health Agency 251S00000X 901 NE

Addresses

Primary practice location

1000 W 29TH St
Suite 320
South Sioux City, NE 68776-3852

Mailing address

1000 W 29TH St
Suite 320
South Sioux City, NE 68776-3852
Phone (712) 574-4357

Other identifiers 1

IdentifierTypeStateIssuer
10026366800MedicaidNE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1372982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419984000000",
    "number": "1003256082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 W 29TH ST",
            "address_2": "SUITE 320",
            "city": "SOUTH SIOUX CITY",
            "state": "NE",
            "postal_code": "687763852",
            "telephone_number": "712-574-4357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W 29TH ST",
            "address_2": "SUITE 320",
            "city": "SOUTH SIOUX CITY",
            "state": "NE",
            "postal_code": "687763852",
            "telephone_number": "712-574-4357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSROADS ADDICTION & MENTAL HEALTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-05",
        "last_updated": "2014-12-31",
        "status": "A",
        "authorized_official_last_name": "JENSEN",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "712-301-4518",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NE",
            "license": "569",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NE",
            "license": "901",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026366800",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Sioux City, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.