Crossroads Counseling Services LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

13033 Issued in MN

Legal business name

CROSSROADS COUNSELING SERVICES LLC

Practice address

6053 Hudson Rd Ste 192
Woodbury, MN 55125-1015

Phone

(651) 276-8446

NPI assigned

Jul 8, 2013

Last updated

Jul 8, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Brenda Kittilson, MS, LICSW, LADC

Title

Owner/Therapist

Phone

(651) 276-8446

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1373241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373241600000",
    "number": "1043651052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6053 HUDSON RD STE 192",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551251015",
            "telephone_number": "651-276-8446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6053 HUDSON RD STE 192",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551251015",
            "telephone_number": "651-276-8446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSROADS COUNSELING SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-08",
        "last_updated": "2013-07-08",
        "status": "A",
        "authorized_official_last_name": "KITTILSON",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "651-276-8446",
        "authorized_official_credential": "MS, LICSW, LADC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "301518",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "13033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alixandra S Crepeau, MD
• Thomas Micheal Crist, DDS
• Laura Critelli
• Catherine A Crosby Schmidt, MD
• Juanita Ann Crosby
• Crosswinds Arts and Science School
• Crown OB/GYN PA
• Megan E Crowston
• Angela Crum
• Peyton Elaine Cudd

• Clinical Social Worker in Woodbury, MN
• Providers in Woodbury, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2013; 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.