Provider Demographics
NPI:1437684800
Name:CRUZ, KATIE T (MA, LPC)
Entity Type:Individual
Prefix:MS
First Name:KATIE
Middle Name:T
Last Name:CRUZ
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 E HALSEY RD STE 354
Mailing Address - Street 2:
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-3713
Mailing Address - Country:US
Mailing Address - Phone:201-898-6013
Mailing Address - Fax:
Practice Address - Street 1:520 N 13TH ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07107-1334
Practice Address - Country:US
Practice Address - Phone:201-898-6013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-24
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor