At a Cross Road Counseling, PLLC

Organization Active NPI Mental Health Counselor · Beaverton, MI

NPI 1780433565 · NPPES record last updated Jul 25, 2024

Key facts

NPI
1780433565
Entity type
Organization (NPI type 2)
Primary specialty
Mental Health Counselor 101YM0800X
Legal business name
AT A CROSS ROAD COUNSELING, PLLC
Practice address
201 S Ross St
Beaverton, MI 48612-8113
Phone
(989) 289-7578
Fax
(989) 435-6038
NPI assigned
May 15, 2024
Organization subpart
No

Authorized official

Name
Cheryl Biddinger
Title
Outpatient Mental Health Therapist
Phone
(989) 289-7578

Practitioners 2

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MI

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20240731003252 MI Part B Supplier - Clinic/Group Practice 8527505114 Receives reassigned benefits from 1 practitioner
Practice locations: Beaverton, MI

National Provider Directory

Locations

201 S Ross St
Beaverton, MI 48612
Phone (989) 289-7578

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor
Group: 193400000X SINGLE SPECIALTY GROUP
101YM0800X Yes

Addresses

Primary practice location

201 S Ross St
Beaverton, MI 48612-8113

Mailing address

4150 Bay Ave
Beaverton, MI 48612-8819
Phone (989) 289-7578

Other providers in Beaverton, MI

All providers in Beaverton, MI · Mental Health Counselor in Michigan

Sources for this page

Verify at the official NPI Registry.