Individual provider Active NPI

Tijuana McLeod Crosby, MA

  • Psychologist
  • Raleigh, NC
National Provider Identifier
1780722801
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2119 Issued in NC
Practice address
9308 Club Hill Dr
Raleigh, NC 27617-7572
Phone
(919) 806-0088
NPI assigned
Feb 1, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2119 NC Primary

Addresses

Primary practice location

9308 Club Hill Dr
Raleigh, NC 27617-7572

Mailing address

9308 Club Hill Dr
Raleigh, NC 27617-7572
Phone (919) 806-0088

Other identifiers 2

IdentifierTypeStateIssuer
046WHOtherNCBCBS
6107407MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240403000909 NC Practitioner - Clinical Psychologist 9335587823 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Step Up Care of North Carolina PCGroup PAC ID 4486036878, 19 clinicians

Practice addresses (Care Compare)

3250 Homestead Club Dr
Winston Salem, NC 27103-6787
Phone (718) 506-1115

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Step Up Care of North Carolina PC CurrentSince Mar 1, 2024 Accepting new patients
Wake Psychological Services, PLLC Past Accepting new patients

Locations

27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780722801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9308 CLUB HILL DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276177572",
            "telephone_number": "919-806-0088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9308 CLUB HILL DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276177572",
            "telephone_number": "919-806-0088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROSBY",
        "first_name": "TIJUANA",
        "middle_name": "MCLEOD",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "2119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "046WH",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6107407",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.