NPIMap

Organization Active NPI

Crossroads Services Board

  • Community/Behavioral Health Agency
  • Farmville, VA
National Provider Identifier
1528091063
Registry record updated Nov 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
CROSSROADS SERVICES BOARD
Practice address
60 Bush River Drive
Farmville, VA 23901
Phone
(434) 392-7049
Fax
(434) 392-9221
NPI assigned
Jul 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2020

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

Authorized official

Name
Michelle Foore
Title
Credentialing Coordinator
Phone
(434) 392-7049

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X
PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103T00000X
Clinical Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1041C0700X
Psychiatry PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2084P0800X
Community/Behavioral Health Agency 251S00000X Primary
Non-emergency Medical Transport (VAN) 343900000X

Addresses

Primary practice location

60 Bush River Drive
Farmville, VA 23901

Mailing address

P.O. Drawer 248
Farmville, VA 23901
Phone (434) 392-7049

Other identifiers 1

IdentifierTypeStateIssuer
004945450MedicaidVA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040415000364 VA Part B Supplier - Clinic/Group Practice 4486649977 Receives reassigned benefits from 33 practitioners
Practice locations: Amelia Court House, VA; Lunenburg, VA; Farmville, VA; Charlotte Court House, VA

National Provider Directory

National Provider Directory

Locations

9101 Washington St
Amelia Court House, VA 23002
Phone (804) 561-5057

410 Thomas Jefferson Hwy
Charlotte Court House, VA 23923
Phone (434) 542-5187

213 Bush River Dr
Farmville, VA 23901
Phone (434) 392-7049

Practitioners & affiliated clinicians

Practitioners 74

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 74

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604880000000",
    "number": "1528091063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. DRAWER 248",
            "city": "FARMVILLE",
            "state": "VA",
            "postal_code": "23901",
            "telephone_number": "434-392-7049",
            "fax_number": "434-392-9221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 BUSH RIVER DRIVE",
            "city": "FARMVILLE",
            "state": "VA",
            "postal_code": "23901",
            "telephone_number": "434-392-7049",
            "fax_number": "434-392-9221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSROADS SERVICES BOARD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-09",
        "status": "A",
        "authorized_official_last_name": "FOORE",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "434-392-7049"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004945450",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2020; 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.