Crossroads Counseling

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

CROSSROADS COUNSELING

Practice address

628 Forest TRL
Argyle, TX 76226-6705

Phone

(817) 966-3910

NPI assigned

Mar 16, 2020

Last updated

Sep 30, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Charles Clifford Borsellino, PHDNPI 1093966541

Title

Manager

Phone

(817) 966-3910

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Practitioners 1

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.

• Charles Clifford Borsellino, PH.D.,PSY.D.

  • Psychologist
  • Argyle, TX
  • NPI 1093966541
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1584316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632960000000",
    "number": "1437785011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "628 FOREST TRL",
            "city": "ARGYLE",
            "state": "TX",
            "postal_code": "762266705",
            "telephone_number": "817-966-3910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "628 FOREST TRL",
            "city": "ARGYLE",
            "state": "TX",
            "postal_code": "762266705",
            "telephone_number": "817-966-3910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSROADS COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-16",
        "last_updated": "2021-09-30",
        "certification_date": "2021-09-30",
        "status": "A",
        "authorized_official_last_name": "BORSELLINO",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "CLIFFORD",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "817-966-3910",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Argyle, TX
• Providers in Argyle, TX by specialty
• Clinical Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2021; 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.