NPIMap

Organization Active NPI

Crossroads Counseling & Training Services

  • Developmentally Disabled Services Day Training Agency
  • Fairbanks, AK
National Provider Identifier
1619028909
Registry record updated Mar 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
License
HC5957 Issued in AK
Legal business name
CROSSROADS COUNSELING & TRAINING SERVICES
Practice address
3180 Peger Rd
Suite 200
Fairbanks, AK 99709-5484
Phone
(907) 455-9737
NPI assigned
Jan 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2017

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

Authorized official

Name
Ms. Nicole Nelson, MPS
Title
Executive Director
Phone
(907) 455-9737

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X HC5957 AK Primary
Respite Care 385H00000X HC5957 AK

Addresses

Primary practice location

3180 Peger Rd
Suite 200
Fairbanks, AK 99709-5484

Mailing address

PO Box 82074
Fairbanks, AK 99708-2074
Phone (907) 455-9737

Other identifiers 1

IdentifierTypeStateIssuer
HC5957MedicaidAK

National Provider Directory

National Provider Directory
Tax ID family
Crossroads Counseling Training Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490745600000",
    "number": "1619028909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 82074",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997082074",
            "telephone_number": "907-455-9737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3180 PEGER RD",
            "address_2": "SUITE 200",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997095484",
            "telephone_number": "907-455-9737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSROADS COUNSELING & TRAINING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-15",
        "last_updated": "2017-03-29",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "907-455-9737",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MPS"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "AK",
            "license": "HC5957",
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "AK",
            "license": "HC5957",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HC5957",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairbanks, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2017; 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.