Organization Active NPI

Crossroads Psychology Center, LLC

  • Professional Counselor
  • Tifton, GA
National Provider Identifier
1417429226
Registry record updated Dec 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
CROSSROADS PSYCHOLOGY CENTER, LLC
Practice address
1017 Central Ave N
Tifton, GA 31794-3967
Phone
(229) 388-0932
Fax
(229) 388-0933
NPI assigned
Dec 19, 2018
Last updated
Dec 19, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2018

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

Authorized official

Name
Vikki Taylor
Title
Office Manager
Phone
(229) 388-0932

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

1017 Central Ave N
Tifton, GA 31794-3967

Mailing address

PO Box 2707
Tifton, GA 31793-2707
Phone (229) 388-0932

National Provider Directory

National Provider Directory

Locations

1017 Central Ave N
Tifton, GA 31794
Phone (229) 388-0932

Practitioners & affiliated clinicians

Practitioners 2

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": "1545177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545177600000",
    "number": "1417429226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2707",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317932707",
            "telephone_number": "229-388-0932",
            "fax_number": "229-388-0933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1017 CENTRAL AVE N",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317943967",
            "telephone_number": "229-388-0932",
            "fax_number": "229-388-0933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSROADS PSYCHOLOGY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-19",
        "last_updated": "2018-12-19",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "VIKKI",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "229-388-0932"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tifton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2018; 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.