Couples at Crossroads, LLC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MF000107 Issued in PA

Legal business name

COUPLES AT CROSSROADS, LLC

Practice address

525 N 12TH St
Suite 100
Lemoyne, PA 17043-1245

Phone

(717) 743-4223

NPI assigned

Jan 10, 2017

Last updated

Jan 11, 2017By 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, PHD

Title

President

Phone

(717) 433-5751

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1484006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484092800000",
    "number": "1689110074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 N 12TH ST",
            "address_2": "SUITE 100",
            "city": "LEMOYNE",
            "state": "PA",
            "postal_code": "170431245",
            "telephone_number": "717-743-4223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 N 12TH ST",
            "address_2": "SUITE 100",
            "city": "LEMOYNE",
            "state": "PA",
            "postal_code": "170431245",
            "telephone_number": "717-743-4223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUPLES AT CROSSROADS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-10",
        "last_updated": "2017-01-11",
        "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": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "PA",
            "license": "MF000107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Lemoyne, PA
• Providers in Lemoyne, 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 Jan 11, 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.