Organization Active NPI

Crossroads Therapeutic Services

  • Counselor
  • Jacksonville, NC
National Provider Identifier
1275946741
Registry record updated Jun 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Legal business name
CROSSROADS THERAPEUTIC SERVICES
Practice address
99 Village Dr
Suite 18-4
Jacksonville, NC 28546-7067
Phone
(910) 939-5144
Fax
(910) 939-5934
NPI assigned
Jun 3, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2014

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

Authorized official

Name
Mrs. Dejuan Joyce Lundy, LPC, LCAS-A
Title
Member/Organizer
Phone
(919) 225-9315

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X Primary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X

Addresses

Primary practice location

99 Village Dr
Suite 18-4
Jacksonville, NC 28546-7067

Mailing address

99 Village Dr
Suite 18-4
Jacksonville, NC 28546-7067
Phone (910) 939-5144

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1401753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402531200000",
    "number": "1275946741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 VILLAGE DR",
            "address_2": "SUITE 18-4",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285467067",
            "telephone_number": "910-939-5144",
            "fax_number": "910-939-5934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 VILLAGE DR",
            "address_2": "SUITE 18-4",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285467067",
            "telephone_number": "910-939-5144",
            "fax_number": "910-939-5934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSROADS THERAPEUTIC SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-03",
        "last_updated": "2014-06-12",
        "status": "A",
        "authorized_official_last_name": "LUNDY",
        "authorized_official_first_name": "DEJUAN",
        "authorized_official_middle_name": "JOYCE",
        "authorized_official_title_or_position": "MEMBER/ORGANIZER",
        "authorized_official_telephone_number": "919-225-9315",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPC, LCAS-A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.