Provider Demographics
NPI:1164962353
Name:CRUZ, SABRINA (MED, ALC, NCC)
Entity Type:Individual
Prefix:MS
First Name:SABRINA
Middle Name:
Last Name:CRUZ
Suffix:
Gender:F
Credentials:MED, ALC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2358 FAIRLANE DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36116-1604
Mailing Address - Country:US
Mailing Address - Phone:334-270-4100
Mailing Address - Fax:334-270-4254
Practice Address - Street 1:2358 FAIRLANE DR
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116-1604
Practice Address - Country:US
Practice Address - Phone:334-270-4100
Practice Address - Fax:334-270-4254
Is Sole Proprietor?:No
Enumeration Date:2017-03-07
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALC2831A101Y00000X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional