Provider Demographics
NPI:1902925464
Name:CRUZ, MARIBEL (MSW)
Entity Type:Individual
Prefix:MS
First Name:MARIBEL
Middle Name:
Last Name:CRUZ
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 ACROPOLIS RD
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01854-1301
Mailing Address - Country:US
Mailing Address - Phone:978-452-9817
Mailing Address - Fax:
Practice Address - Street 1:650 SUFFOLK ST
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01854-3642
Practice Address - Country:US
Practice Address - Phone:978-452-5155
Practice Address - Fax:978-970-0713
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA283101YA0400X
MA1017862101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health