Provider Demographics
NPI:1164618690
Name:AT THE CROSSROADS MENTAL HEALTH COUNSELING, PC
Entity type:Organization
Organization Name:AT THE CROSSROADS MENTAL HEALTH COUNSELING, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / SENIOR COUNSELOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUISE
Authorized Official - Middle Name:D
Authorized Official - Last Name:NIELSEN
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, NCC, MA
Authorized Official - Phone:845-527-6880
Mailing Address - Street 1:621 ROUTE 52
Mailing Address - Street 2:
Mailing Address - City:BEACON
Mailing Address - State:NY
Mailing Address - Zip Code:12508-1235
Mailing Address - Country:US
Mailing Address - Phone:845-527-6880
Mailing Address - Fax:845-831-1579
Practice Address - Street 1:621 ROUTE 52
Practice Address - Street 2:
Practice Address - City:BEACON
Practice Address - State:NY
Practice Address - Zip Code:12508-1235
Practice Address - Country:US
Practice Address - Phone:845-527-6880
Practice Address - Fax:845-831-1579
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-18
Last Update Date:2009-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000031251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY004264OtherLMHC LICENCE
NY000031OtherLMHC LICENSE