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CROSSROADS TREATMENT CENTER OF SUFFOLK, PC
NPI 1245758135
Clinic/Center - Methadone in Suffolk, VA

Active since August 31, 2017CLIA 49D2136206 · Waiver
1258 HOLLAND RD, SUFFOLK, VA 23434(757) 809-4771(757) 809-4932 Get Directions Write a Review

NPPES record last updated: September 3, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Sep 3, 2024, Nov 19, 2021, Aug 31, 2017 (3 updates tracked since 2017).

About Crossroads Treatment Center Of Suffolk, Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CROSSROADS TREATMENT CENTER OF SUFFOLK, PC (NPI 1245758135) is a healthcare organization registered as a methadone in Suffolk, Virginia and active in the NPI registry since August 2017. The organization holds a CLIA Waiver certificate valid through September 4, 2027 and lists Rupert Mccormac, Chief Executive Officer, as its authorized official.

NPPES Registry Identity

NPI1245758135
Entity TypeOrganization
Primary Taxonomy261QM2800X
Legal Business NameCROSSROADS TREATMENT CENTER OF SUFFOLK, PC
Location Address1258 HOLLAND RDSuffolk, VA 23434-6313
Mailing AddressPo Box 749057Atlanta, GA 30374-9057 · (800) 805-6989 · Fax (864) 990-0653
Phone(757) 809-4771
Fax(757) 809-4932
Organization SubpartNo
Authorized OfficialRupert MccormacChief Executive Officer · (800) 805-6989
Enumeration DateAugust 31, 2017
Last NPPES UpdateSeptember 3, 20243 updates tracked since enumeration
NPPES CertifiedSeptember 3, 2024
✔ NPI 1245758135 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 6

★ Primary SpecialtyClinic/Center · MethadoneAmbulatory Health Care Facilities
Taxonomy Code261QM2800X
Definition

An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction.

Also ListedCommunity/Behavioral HealthTaxonomy 251S00000X
Also ListedClinic/Center · Mental Health (Including Community Mental Health Center)Taxonomy 261QM0801X
Also ListedClinic/Center · Multi-SpecialtyTaxonomy 261QM1300X
Also ListedClinic/Center · Primary CareTaxonomy 261QP2300X
Also ListedClinic/Center · Rehabilitation, Substance Use DisorderTaxonomy 261QR0405X
1258 HOLLAND RD, Suffolk, VA 23434
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 49D2136206

Crossroads Treatment Center Of Suffolk, PC · Suffolk, VA
Active · expires Sep 4, 2027
CLIA Number49D2136206
Laboratory TypeOpioid Treatment Program
Certificate Effective DateSeptember 5, 2025
Certificate Expiration DateSeptember 4, 2027
Laboratory DirectorJames Stephen
Laboratory Phone(757) 809-4771
Laboratory LocationCrossroads Treatment Center Of Suffolk, PC1258 Holland Road, Suffolk, VA 23434
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARY CATHERINE DILLARD
Registered Nurse
1258 HOLLAND RD
SUFFOLK, VA 23434
Suffolk City (757) 809-4771
PATRICIA BROWN
Counselor (Addiction (Substance Use Disorder))
1258 HOLLAND RD
SUFFOLK, VA 23434
Suffolk City (757) 809-4771
MISS TAKIMA SIMMONS LPC-R, CSAC-S
Counselor (Professional)
1258 HOLLAND RD
SUFFOLK, VA 23434
Suffolk City (800) 805-6989
ANTOINETTE L PORTER
Counselor (Addiction (Substance Use Disorder))
1258 HOLLAND RD
SUFFOLK, VA 23434
Suffolk City (757) 409-4771
PHILLIP EDWARD MAYBERY CSAC
Counselor
1258 HOLLAND RD
SUFFOLK, VA 23434
Suffolk City (757) 439-2698
EBONY IRVIN CCMA
Physician Assistant (Medical)
1258 HOLLAND RD
SUFFOLK, VA 23434
Suffolk City (877) 848-9810
BEN DRAGAN ZORN
Counselor (Addiction (Substance Use Disorder))
1258 HOLLAND RD
SUFFOLK, VA 23434
Suffolk City (800) 805-6989
ERIN MARIE HOUGH CSAC-S
Counselor (Addiction (Substance Use Disorder))
1258 HOLLAND RD
SUFFOLK, VA 23434
Suffolk City (877) 848-9810

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Crossroads Treatment Center Of Suffolk, PC's NPI number?

The NPI number for Crossroads Treatment Center Of Suffolk, PC is 1245758135. It was assigned to this organization in the NPPES registry on August 31, 2017.

Where is Crossroads Treatment Center Of Suffolk, PC located?

Crossroads Treatment Center Of Suffolk, PC is located at 1258 Holland Rd, Suffolk, VA 23434. The listed phone number is (757) 809-4771.

What is Crossroads Treatment Center Of Suffolk, PC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Methadone, with taxonomy code 261QM2800X.

Does Crossroads Treatment Center Of Suffolk, PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 49D2136206) is associated with this NPI, valid through September 4, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Crossroads Treatment Center Of Suffolk, PC was last updated on September 3, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.