Individual provider Active NPI

Sherry Rene Rosenblad, PH.D., LPC-S

  • Professional Counselor
  • Abilene, TX
National Provider Identifier
1154644060
Registry record updated Sep 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
63895 Issued in TX
Practice address
279 N Willis St Ste C
Abilene, TX 79603-6993
Phone
(325) 261-0137
Fax
(833) 233-4071
NPI assigned
Mar 5, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 63895 TX Primary

Addresses

Primary practice location

279 N Willis St Ste C
Abilene, TX 79603-6993

Mailing address

279 N Willis St Ste C
Abilene, TX 79603-6993
Phone (325) 261-0137

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address management@crossroadscounseling.life Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240110001429 TX Practitioner - Mental Health Counselor 7416308879 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
63895TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Crossroads Counseling and Wellness LLC Professional CurrentSince Jul 10, 2022 Accepting new patients
Texas Tech University Health Sciences Center Lubbock Current Accepting new patients
Texas Tech University Health Sciences Center Lubbock CurrentSince Jan 1, 2024 Accepting new patients
Crossroads Counseling Abilene LLC CurrentSince Sep 5, 2021 Accepting new patients
Texas Tech University Health Sciences Center Lubbock Current Accepting new patients
Texas Tech University Health Sciences Center Lubbock CurrentSince Jan 1, 2024 Accepting new patients
Prevail Counseling & Forensic Mental Health Consulting, P.C. Professional Past Accepting new patients

Locations

279 N Willis St
Ste C
Abilene, TX 79603
Phone (325) 261-0137

4000 24th St
#410
Lubbock, TX 79410
Phone (806) 743-7700

3601 4th St
#3A250
Lubbock, TX 79430
Phone (806) 743-2018

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1267747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1154644060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "279 N WILLIS ST STE C",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796036993",
            "telephone_number": "325-261-0137",
            "fax_number": "833-233-4071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "279 N WILLIS ST STE C",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796036993",
            "telephone_number": "325-261-0137",
            "fax_number": "833-233-4071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBLAD",
        "first_name": "SHERRY",
        "middle_name": "RENE",
        "name_prefix": "Dr.",
        "credential": "PH.D., LPC-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-05",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "63895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "management@crossroadscounseling.life",
            "affiliation": "N",
            "endpointDescription": "manager email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "279 N Willis St Ste C",
            "city": "Abilene",
            "state": "TX",
            "country_code": "US",
            "postal_code": "796036993",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Abilene, TX

Sources for this page

Verify at the official NPI Registry.