Organization Active NPI

Cedar Crossing Counseling, LLC

  • Professional Counselor
  • Boerne, TX
National Provider Identifier
1982286662
Registry record updated Dec 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
CEDAR CROSSING COUNSELING, LLC
Practice address
203 Saddle Mountain Dr
Boerne, TX 78006-3821
Phone
(361) 816-2327
NPI assigned
Apr 22, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2023

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

Authorized official

Name
Kimberly J Benedict, LPCNPI 1407272461
Title
Provider, Owner
Phone
(361) 816-2327

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

203 Saddle Mountain Dr
Boerne, TX 78006-3821

Mailing address

PO Box 2304
Boerne, TX 78006-6304
Phone (361) 816-2327

Other identifiers 1

IdentifierTypeStateIssuer
424898101MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231207000301 TX Part B Supplier - Clinic/Group Practice 2466801105 Receives reassigned benefits from 1 practitioner
Practice locations: Boerne, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1619049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701820800000",
    "number": "1982286662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2304",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780066304",
            "telephone_number": "361-816-2327",
            "fax_number": "361-257-1776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 SADDLE MOUNTAIN DR",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780063821",
            "telephone_number": "361-816-2327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDAR CROSSING COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-22",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A",
        "authorized_official_last_name": "BENEDICT",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PROVIDER, OWNER",
        "authorized_official_telephone_number": "361-816-2327",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "424898101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boerne, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.