Provider Demographics
NPI:1164658191
Name:CRUZ, MONICA LYNN (LCSW-BACS)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:LYNN
Last Name:CRUZ
Suffix:
Gender:F
Credentials:LCSW-BACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLINTON
Mailing Address - State:LA
Mailing Address - Zip Code:70438-1718
Mailing Address - Country:US
Mailing Address - Phone:985-322-2026
Mailing Address - Fax:985-322-2026
Practice Address - Street 1:915 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:FRANKLINTON
Practice Address - State:LA
Practice Address - Zip Code:70438-1718
Practice Address - Country:US
Practice Address - Phone:985-322-2026
Practice Address - Fax:985-839-5912
Is Sole Proprietor?:No
Enumeration Date:2009-06-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA10398104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker