Organization Active NPI

Crossroads Therapy LLC

  • Clinical Social Worker
  • Charlotte, NC
National Provider Identifier
1629497300
Registry record updated Jul 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C005971 Issued in NC
Legal business name
CROSSROADS THERAPY LLC
Practice address
3440 Toringdon Way
Suite 205
Charlotte, NC 28277-3190
Phone
(704) 325-5850
Fax
(704) 585-1086
NPI assigned
Apr 10, 2014
Last updated
Jul 14, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2014

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

Authorized official

Name
Mrs. Shirley Hijin Brown, LCSW
Title
Licensed Clinical Social Worker
Phone
(704) 877-8655

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C006772 NC
Clinical Social Worker 1041C0700X C006866 NC
Clinical Social Worker 1041C0700X C005971 NC Primary

Addresses

Primary practice location

3440 Toringdon Way
Suite 205
Charlotte, NC 28277-3190

Mailing address

3440 Toringdon Way
Suite 205
Charlotte, NC 28277-3190
Phone (704) 325-5850

National Provider Directory

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, 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": "1397088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405296000000",
    "number": "1629497300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3440 TORINGDON WAY",
            "address_2": "SUITE 205",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282773190",
            "telephone_number": "704-325-5850",
            "fax_number": "704-585-1086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3440 TORINGDON WAY",
            "address_2": "SUITE 205",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282773190",
            "telephone_number": "704-325-5850",
            "fax_number": "704-585-1086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSROADS THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-10",
        "last_updated": "2014-07-14",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "SHIRLEY",
        "authorized_official_middle_name": "HIJIN",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "704-877-8655",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C006772",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C006866",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C005971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 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.