Provider Demographics
NPI:1598110306
Name:CRUZ-VEGA, TAMARA (BS, MSW)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:
Last Name:CRUZ-VEGA
Suffix:
Gender:F
Credentials:BS, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 BERKMANS ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01602-3320
Mailing Address - Country:US
Mailing Address - Phone:774-242-1809
Mailing Address - Fax:
Practice Address - Street 1:34 BERKMANS ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01602-3320
Practice Address - Country:US
Practice Address - Phone:774-242-1809
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-29
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)