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CROSSROAD THERAPY, LLC
NPI 1790161016
Social Worker - Clinical in Mukwonago, WI

Active since August 10, 2015
S110W30520 YMCA CAMP RD, MUKWONAGO, WI 53149(262) 777-1833(262) 363-0973 Get Directions Write a Review

NPPES record last updated: August 10, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Crossroad Therapy, Llc NPPES

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

CROSSROAD THERAPY, LLC (NPI 1790161016) is a healthcare organization registered as a clinical in Mukwonago, Wisconsin and active in the NPI registry since August 2015. The organization lists Fred Malesevich, Owner, as its authorized official.

NPPES Registry Identity

NPI1790161016
Entity TypeOrganization
Primary Taxonomy1041C0700X
Legal Business NameCROSSROAD THERAPY, LLC
Location AddressS110W30520 YMCA CAMP RDMukwonago, WI 53149-9534
Mailing AddressS110w30520 Ymca Camp RdMukwonago, WI 53149-9534 · (262) 777-1833 · Fax (262) 363-0973
Phone(262) 777-1833
Fax(262) 363-0973
Organization SubpartNo
Authorized OfficialFred MalesevichOwner · (262) 777-1833
Enumeration DateAugust 10, 2015
✔ NPI 1790161016 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in WI · 62-123
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
S110W30520 YMCA CAMP RD, Mukwonago, WI 53149
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

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

MR. FRED HENRY MALESEVICH LCSW, ACSW, DAPA
Social Worker (Clinical)
S110W30520 YMCA CAMP RD
MUKWONAGO, WI 53149
Waukesha County (262) 777-1833

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 Crossroad Therapy, LLC's NPI number?

The NPI number for Crossroad Therapy, LLC is 1790161016. It was assigned to this organization in the NPPES registry on August 10, 2015.

Where is Crossroad Therapy, LLC located?

Crossroad Therapy, LLC is located at S110w30520 Ymca Camp Rd, Mukwonago, WI 53149. The listed phone number is (262) 777-1833.

What is Crossroad Therapy, LLC's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

When was this NPI record last updated?

The NPPES record for Crossroad Therapy, LLC was last updated on August 10, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.