Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Crossroad Therapy, LLC

Organization Clinical Social Worker · NPI 1790161016

Crossroad Therapy, LLC is a Clinical Social Worker in Mukwonago, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2015.

Licensed in
WI
In the registry since
2015
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

S110W30520 YMCA Camp Rd
Mukwonago, WI 53149-9534
Phone: (262) 777-1833
Fax: (262) 363-0973
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 62-123 (WI)

Record details

NPI number1790161016
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Fred Malesevich — Owner · (262) 777-1833
NPI enumeratedAugust 10, 2015
Last updated in NPPESAugust 10, 2015
Mailing addressS110w30520 Ymca Camp Rd, Mukwonago, WI 53149-9534

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