Crossroads Behavioral Health, LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1631 Issued in CT

Legal business name

CROSSROADS BEHAVIORAL HEALTH, LLC

Practice address

10 N. Main St
Suite 204
West Hartford, CT 06107

Phone

(860) 233-8111

Fax

(860) 236-2016

NPI assigned

Apr 18, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Susan E Peterman, PHD

Title

Owner

Phone

(860) 233-8111

Specialties & licenses 1

Addresses

Other names 1

• LLC Other name

Locations

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576627200000",
    "number": "1356567341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 N. MAIN ST",
            "address_2": "SUITE 204",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "06107",
            "telephone_number": "860-233-8111",
            "fax_number": "860-236-2016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 N. MAIN ST",
            "address_2": "SUITE 204",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "06107",
            "telephone_number": "860-233-8111",
            "fax_number": "860-236-2016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSROADS BEHAVIORAL HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-18",
        "last_updated": "2019-12-18",
        "certification_date": "2019-12-18",
        "status": "A",
        "authorized_official_last_name": "PETERMAN",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-233-8111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "1631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LLC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Cristina Alejandra Cruz Cortes, MD
• Alexis A Cruz
• Crystal Vision West Hartford LLC.

• Clinical Psychologist in West Hartford, CT
• Providers in West Hartford, CT by specialty
• Clinical Psychologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2019; 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.