NPIMap

Organization Active NPI

Cross Connections, Inc

  • Mental Health Counselor
  • Fort Wayne, IN
National Provider Identifier
1285112060
Registry record updated Aug 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
CROSS CONNECTIONS, INC
Practice address
4618 E State Blvd Ste 300
Fort Wayne, IN 46815-6966
Phone
(260) 373-0213
Fax
(260) 373-0218
NPI assigned
Aug 2, 2018
Last updated
Aug 2, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2018

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

Authorized official

Name
Matthew Konow
Title
Executive Director
Phone
(260) 373-0213

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Mental Health Counselor 101YM0800X Primary
Social Worker 104100000X
Marriage & Family Therapist 106H00000X

Addresses

Primary practice location

4618 E State Blvd Ste 300
Fort Wayne, IN 46815-6966

Mailing address

4618 E State Blvd Ste 300
Fort Wayne, IN 46815-6966
Phone (260) 373-0213

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250912002337 IN Part B Supplier - Clinic/Group Practice 5193228385 Receives reassigned benefits from 4 practitioners
Practice locations: Fort Wayne, IN

National Provider Directory

National Provider Directory

Locations

4618 E State Blvd
Ste 300
Fort Wayne, IN 46815
Phone (260) 373-0213

Practitioners & affiliated clinicians

Practitioners 7

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": "1533168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533168000000",
    "number": "1285112060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4618 E STATE BLVD STE 300",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468156966",
            "telephone_number": "260-373-0213",
            "fax_number": "260-373-0218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4618 E STATE BLVD STE 300",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468156966",
            "telephone_number": "260-373-0213",
            "fax_number": "260-373-0218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSS CONNECTIONS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-02",
        "last_updated": "2018-08-02",
        "status": "A",
        "authorized_official_last_name": "KONOW",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "260-373-0213"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.