| Roots At Crossroads Counseling Llc | |
|
2040 Millburn Ave Ste 102 Maplewood NJ 07040-3716 | |
| (908) 798-4809 | |
| Not Available |
| Full Name | Roots At Crossroads Counseling Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 2040 Millburn Ave Ste 102, Maplewood, New Jersey |
| Authorized Official Name and Position | Sevil H Modeste (CEO) |
| Authorized Official Contact | 9087984809 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Roots At Crossroads Counseling Llc 2040 Millburn Ave Ste 102 Maplewood NJ 07040-3716 Ph: () - | Roots At Crossroads Counseling Llc 2040 Millburn Ave Ste 102 Maplewood NJ 07040-3716 Ph: (908) 798-4809 |
| NPI Number | 1043964091 |
|---|---|
| Provider Enumeration Date | 02/08/2022 |
| Last Update Date | 09/09/2022 |
| Certification Date | 09/09/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043964091 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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