CROSSROADS COUNSELING & PSYCHOTHERAPY, LLC (NPI# 1962989442) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962989442 |
| Entity Type | Organization |
| Organization Name | CROSSROADS COUNSELING & PSYCHOTHERAPY, LLC |
| Practice Address |
163 Dayton St Ridgewood NJ 07450-4407 |
| Mailing Address |
115 Franklin Tpke # 198 Mahwah NJ 07430-1325 |
| Practice Telephone | 2016941648 |
| Mailing Telephone | 2016941648 |
| Enumeration Date | 2018-07-26 |
| Last Update Date | 2018-07-26 |
| Authorized Official Name | DEBORAH RIZZO KOURGELIS (OWNER) |
| Authorized Official Telephone | 2016941648 |
| Authorized Official Credential | LCSW, LCADC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1041C0700X |
Social Worker Specialization: Clinical |
44SC05300400 | NJ | Behavioral Health & Social Service Providers |
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
37LC00165200 | NJ | Behavioral Health & Social Service Providers |
| Street Address |
163 DAYTON ST |
| City | RIDGEWOOD |
| State | NJ |
| Zip Code | 07450-4407 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881622140 | Joseph Panepinto | Social Worker | 163 Dayton St, Ridgewood, NJ 07450-4407 | 2006-06-28 |
| 1700029477 | Deborah R. Kourgelis | Social Worker | 163 Dayton St, Ridgewood, NJ 07450-4407 | 2009-04-10 |
| 1255548384 | Thomas Sherlock | Dentist | 163 Dayton St, Ridgewood, NJ 07450-4407 | 2007-05-17 |
| 1912121021 | Joseph A Lota | Dentist | 163 Dayton St, Ridgewood, NJ 07450-4407 | 2007-04-12 |
| 1629100615 | Vikki Raider | Social Worker | 163 Dayton St, Ridgewood, NJ 07450-4407 | 2007-03-12 |
| 1477653079 | Vahan Alexander Kehayan | Psychologist | 163 Dayton St, Ridgewood, NJ 07450-4407 | 2006-09-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023675857 | Children's Aid and Family Services, Inc. | Behavioral Analyst | 213 Larue Road, W. Milford, NJ 07450 | 2019-05-28 |
| 1962065979 | Corey Chan | Student in an Organized Health Care Education/Training Program | 550 Lynn St, Ridgewood, NJ 07450 | 2019-04-16 |
| 1679058200 | Raymond Hawash | Pharmacist | 223 North Van Dien Ave, Ridgewood, NJ 07450 | 2018-09-28 |
| 1548771967 | Leonard Swerdlof | Dentist | 160 S Broad St, Ridgewood, NJ 07450 | 2017-10-12 |
| 1336671114 | Camp Sunshine and Camp Snowflake, Inc. | Respite Care | 1133 East Ridgewood Avenue, Ridgewood, NJ 07450 | 2017-03-30 |
| 1952764862 | Elysium Aesthetics and Vein Care, Inc | Radiology | 400 State Route 17, Ridgewood, NJ 07450 | 2016-03-30 |
| 1780077362 | Paul Walter Dasher | Psychologist | 76 West Ridgewood Avenue, Ridgewood, NJ 07450 | 2015-03-06 |
| 1255750071 | Myron Frank Lesh | Pharmacist | 305 E. Ridgewood Ave., Ridgewood, NJ 07450 | 2014-04-09 |
| 1649612912 | Jane Worthman-leva | Nutritionist | 357 South Irving St, Ridgewood, NJ 07450 | 2013-07-26 |
| 1427398858 | Life Opportunities Unlimited A Non Profit Corp. | Day Training, Developmentally Disabled Services | 75 North Maple Ave, Suite 104, Ridgewood, NJ 07450 | 2013-02-21 |
| Find all providers in zip 07450 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063067759 | Paula Lynn Kaplan | Counselor | 75 N Maple Ave Ste 201, Ridgewood, NJ 07450-3261 | 2019-08-08 |
| 1366862112 | Lorayne Coneys | Counselor | 102 S Maple Ave, Ridgewood, NJ 07450-4560 | 2014-04-21 |
| 1023387016 | Anna Dec | Counselor | 6801 Fresh Pond Rd, Apt.2f, Ridgewood, NY 11385-5233 | 2011-12-20 |
| 1275818007 | Edward R. Hernandez | Counselor | 2016 Himrod St, Ridgewood, NY 11385-1233 | 2011-10-12 |
| 1205047974 | Ludwig Philipp Hauser | Counselor | 5924 Norman St, Ridgewood, NY 11385-5935 | 2007-05-24 |
| 1063564094 | Steven H Khanjian | Counselor | 1172 E Ridgewood Ave Ste 4, Ridgewood, NJ 07450-3928 | 2007-01-18 |
| 1497804553 | David Richard Johnson | Counselor | 1156 E Ridgewood Ave, Suite 4, Ridgewood, NJ 07450-3935 | 2007-01-09 |
| 1376690347 | Michael Douglas James | Counselor | 61 North Maple Avenue, Suite 101c, Ridgewood, NJ 07450 | 2007-01-04 |
| 1386993970 | Summer B Brancoccio | Counselor | 120 Chestnut Street, Ridgewood, NJ 07450 | 2012-08-29 |
| 1851696397 | Denis Eduardo Blumberg, Lcsw, P.C. | Counselor | 5619 Metropolitan Ave, Ridgewood, NY 11385-1958 | 2011-01-13 |
| Find all providers in RIDGEWOOD | ||||
Please comment or provide details below to improve the information on CROSSROADS COUNSELING & PSYCHOTHERAPY, LLC.
| 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.