Crossroads Counseling of Southeast Oklahoma, PLLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

3710 Issued in OK

Legal business name

CROSSROADS COUNSELING OF SOUTHEAST OKLAHOMA, PLLC

Practice address

620 E Court St
Atoka, OK 74525-3016

Phone

(580) 364-0170

Fax

(580) 364-0170

NPI assigned

Jul 23, 2012

Last updated

Jul 23, 2012By 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

Ms. Carrie J Tisdale, M.ED., LPCNPI 1710154638

Title

Ceo

Phone

(918) 497-8859

Specialties & licenses 1

Addresses

Locations

Practitioners 3

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.

• Carrie J Tisdale, M.ED., LPC

  • Professional Counselor
  • Atoka, OK
  • NPI 1710154638
  Authorized official Same address or phone
• Teresa Ann Atwell

  • Specialist
  • Atoka, OK
  • NPI 1619274958
  NPD (past)
• Connie May Martin, BS, BA

  • Specialist
  • Atoka, OK
  • NPI 1366692675
  NPD (past)

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

{
    "created_epoch": "1343001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343001600000",
    "number": "1699020974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 E COURT ST",
            "city": "ATOKA",
            "state": "OK",
            "postal_code": "745253016",
            "telephone_number": "580-364-0170",
            "fax_number": "580-364-0170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 E COURT ST",
            "city": "ATOKA",
            "state": "OK",
            "postal_code": "745253016",
            "telephone_number": "580-364-0170",
            "fax_number": "580-364-0170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSROADS COUNSELING OF SOUTHEAST OKLAHOMA, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-23",
        "last_updated": "2012-07-23",
        "status": "A",
        "authorized_official_last_name": "TISDALE",
        "authorized_official_first_name": "CARRIE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "918-497-8859",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.ED., LPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "OK",
            "license": "3710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheryl Craft, BA
• Creoks Mental Health Services
• Creoks Mental Health Services Inc
• Creoks Mental Health Services Inc
• Creoks Mental Health Services, Inc
• Jamie Crow, LPC UNDER SUP
• Wyleah Yvette Cubit, CARE COORDINATOR
• Christi Curry
• Custom Dental of Atoka PLLC
• Julianne Daffern

• Community/Behavioral Health Agency in Atoka, OK
• Providers in Atoka, OK by specialty
• Community/Behavioral Health Agency in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2012; 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.