Provider Demographics
NPI:1144001454
Name:CROSSROADS CONSULTING GR LLC
Entity type:Organization
Organization Name:CROSSROADS CONSULTING GR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:F
Authorized Official - Last Name:BARNETT
Authorized Official - Suffix:
Authorized Official - Credentials:LLMSW, CPRM, DP-C
Authorized Official - Phone:616-514-0547
Mailing Address - Street 1:856 DICKINSON ST SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49507-2043
Mailing Address - Country:US
Mailing Address - Phone:616-514-0547
Mailing Address - Fax:
Practice Address - Street 1:856 DICKINSON ST SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49507-2043
Practice Address - Country:US
Practice Address - Phone:616-514-0547
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-12
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty