Couples at Crossroads

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MF000107 Issued in PA

Legal business name

COUPLES AT CROSSROADS

Practice address

5006 Lenker St
Mechanicsburg, PA 17050-3202

Phone

(717) 433-5751

NPI assigned

Apr 21, 2014

Last updated

Apr 21, 2014By 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

Jake D Thiessen, PHDNPI 1023099264

Title

President

Phone

(717) 433-5751

Specialties & licenses 1

Addresses

Locations

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.

• Jake D Thiessen, PHD

  • Marriage & Family Therapist
  • Mechanicsburg, PA
  • NPI 1023099264
  Authorized official Same address or phone

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

{
    "created_epoch": "1398038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398038400000",
    "number": "1578983219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5006 LENKER ST",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170503202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5006 LENKER ST",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170503202",
            "telephone_number": "717-433-5751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUPLES AT CROSSROADS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-21",
        "last_updated": "2014-04-21",
        "status": "A",
        "authorized_official_last_name": "THIESSEN",
        "authorized_official_first_name": "JAKE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "717-433-5751",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "PA",
            "license": "MF000107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Mechanicsburg, PA
• Providers in Mechanicsburg, PA by specialty
• Marriage & Family Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2014; 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.