Provider Demographics
NPI:1356480073
Name:CRUZ-MARTINEZ, YOLANDA (LCSW)
Entity Type:Individual
Prefix:
First Name:YOLANDA
Middle Name:
Last Name:CRUZ-MARTINEZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 DAVENPORT AVE APT 2H
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10805-3403
Mailing Address - Country:US
Mailing Address - Phone:914-995-5233
Mailing Address - Fax:
Practice Address - Street 1:112 E POST RD FL 2
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-5113
Practice Address - Country:US
Practice Address - Phone:914-995-6074
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR026026-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN69191Medicare UPIN