Cross Creek Counseling Center, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2003002001 Issued in MO

Legal business name

CROSS CREEK COUNSELING CENTER, LLC

Practice address

320 Ichord Ave
Suite C
Waynesville, MO 65583-3600

Phone

(573) 774-5800

Fax

(314) 255-1856

NPI assigned

Jul 22, 2013

Organization subpart

No

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

Authorized official

Name

Mr. James M White

Title

Office Manager

Phone

(417) 260-5228

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1374451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374451200000",
    "number": "1407298276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 ICHORD AVE",
            "address_2": "SUITE C",
            "city": "WAYNESVILLE",
            "state": "MO",
            "postal_code": "655833600",
            "telephone_number": "573-774-5800",
            "fax_number": "314-255-1856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 ICHORD AVE",
            "address_2": "SUITE C",
            "city": "WAYNESVILLE",
            "state": "MO",
            "postal_code": "655833600",
            "telephone_number": "573-774-5800",
            "fax_number": "314-255-1856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSS CREEK COUNSELING CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-22",
        "last_updated": "2013-07-22",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "417-260-5228",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2003002001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Waynesville, MO
• Providers in Waynesville, MO by specialty
• Professional Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.