Provider Demographics
NPI:1598465213
Name:SANTACRUZ, BRENDA (LMSW)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:
Last Name:SANTACRUZ
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2904 BRONTE BLVD
Mailing Address - Street 2:
Mailing Address - City:HEARTLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75126-3524
Mailing Address - Country:US
Mailing Address - Phone:682-408-2671
Mailing Address - Fax:
Practice Address - Street 1:2904 BRONTE BLVD
Practice Address - Street 2:
Practice Address - City:HEARTLAND
Practice Address - State:TX
Practice Address - Zip Code:75126-3524
Practice Address - Country:US
Practice Address - Phone:682-408-2671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-09
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106230104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker