CROSSROADS TREATMENT CENTER OF COLUMBIA, PC (NPI# 1578006433) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578006433 |
| Entity Type | Organization |
| Organization Name | CROSSROADS TREATMENT CENTER OF COLUMBIA, PC |
| Practice Address |
1421 Bluff Rd Columbia SC 29201-4809 |
| Practice Telephone | 8037335855 |
| Enumeration Date | 2016-11-28 |
| Last Update Date | 2019-08-03 |
| Authorized Official Name | DR. RUPERT J. MCCORMAC IV (CEO) |
| Authorized Official Telephone | 8287192753 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
| Street Address |
1421 BLUFF RD |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29201-4809 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689950636 | Crossroads Treatment Center of Columbia | Pharmacy | 1421 Bluff Rd, Columbia, SC 29201-4809 | 2011-10-21 |
| 1659971836 | Shelly Chaplin | Counselor | 1421 Bluff Rd, Columbia, SC 29201-4809 | 2020-10-28 |
| 1568061034 | Shenetra Harbour | Registered Nurse | 1421 Bluff Rd, Columbia, SC 29201-4809 | 2020-10-25 |
| 1417562182 | James Inyangetor | Pharmacist | 1421 Bluff Rd, Columbia, SC 29201-4809 | 2020-09-10 |
| 1538784590 | Coleen Louise Murray | Registered Nurse | 1421 Bluff Rd, Columbia, SC 29201-4809 | 2020-06-15 |
| 1164068771 | Rosalyn Iola Harris | Licensed Vocational Nurse | 1421 Bluff Rd, Columbia, SC 29201-4809 | 2019-11-19 |
| 1548813843 | Demetrius Delores Livingston | Licensed Practical Nurse | 1421 Bluff Rd, Columbia, SC 29201-4809 | 2019-07-17 |
| 1952814840 | Marcie Booker | Counselor | 1421 Bluff Rd, Columbia, SC 29201-4809 | 2017-11-14 |
| 1891208955 | Latasha Frazier | Counselor | 1421 Bluff Rd, Columbia, SC 29201-4809 | 2017-11-13 |
| 1386157428 | Karrie Allen | Counselor | 1421 Bluff Rd, Columbia, SC 29201-4809 | 2017-11-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366049421 | Souzan Moslehshirazi | Behavior Technician | 1320 Main Street Suite 300, Colombia, SC 29201 | 2020-10-02 |
| 1295353936 | Kayla Faylyn Nicole Mckenzie | Specialist/Technologist | 1905 Southern Drive, Unit 1905a, Columbia, SC 29201 | 2020-07-09 |
| 1548887128 | Casania's Caring Hands,llc | Home Health Aide | 1113 Belleview Street, 105, Columbia, SC 29201 | 2020-06-30 |
| 1639719909 | Benjamin Clark Watson | Acupuncturist | 1825 Sumter St., Columbia, SC 29201 | 2020-01-14 |
| 1588217574 | Aneika Daley | Specialist/Technologist | 1211 Wheat St, Columbia, SC 29201 | 2019-07-19 |
| 1447803531 | Gillian Taylor Shaughnessy | Specialist/Technologist | 147 South Marion St, Columbia, SC 29201 | 2019-07-18 |
| 1417417619 | Maria Nelson | Behavior Technician | 320 Main St Suite 300, Columbia, SC 29201 | 2019-03-22 |
| 1679041297 | Nathaniel Carl Stocker | Nurse Practitioner | 1614 Main Street, Suite C, Sc House Calls Inc, Columbia, SC 29201 | 2018-11-13 |
| 1558852855 | The Practice | Family Medicine | 1910 Gregg Street, Columbia, SC 29201 | 2018-05-22 |
| 1871095836 | Kadesjah Samuels | Behavior Technician | 1320 Main Street, Suite 300, Columbia, SC 29201 | 2018-03-06 |
| Find all providers in zip 29201 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
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| 1801131420 | Recoverylife, LLC | Clinic/Center | 2246 Sumter St, Columbia, SC 29201-1932 | 2012-12-07 |
| 1902940976 | Drug and Alcohol Rehabiliation Services, Inc. | Clinic/Center | 1290 Prospect Road, Columbia, PA 17512 | 2007-02-16 |
| 1760902563 | Reclaim You, LLC | Clinic/Center | 8815 Centre Park Dr Ste 300, Columbia, MD 21045-2299 | 2017-06-22 |
| 1013466937 | Life Renewal Services | Clinic/Center | 10805 Hickory Ridge Rd, Suite 103, Columbia, MD 21044-3626 | 2016-10-04 |
| 1811446057 | Life's Potential Services | Clinic/Center | 10805 Hickory Ridge Rd, Suite 103, Columbia, MD 21044-3626 | 2016-09-29 |
| 1912354572 | Phoenix Programs, Inc. | Clinic/Center | 90 E Leslie Ln, Columbia, MO 65202-1535 | 2016-05-24 |
| 1013361062 | Maryland Treatment Centers, Inc. | Clinic/Center | 8930 Stanford Blvd, Columbia, MD 21045-5805 | 2016-04-15 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.