Provider Demographics
NPI:1689954281
Name:CRUZ, DIONISIO (LCSW)
Entity Type:Individual
Prefix:MR
First Name:DIONISIO
Middle Name:
Last Name:CRUZ
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:MR
Other - First Name:DENNIS
Other - Middle Name:
Other - Last Name:CRUZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:658 UNION ST
Mailing Address - Street 2:APARTMENT A
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-1103
Mailing Address - Country:US
Mailing Address - Phone:347-528-7325
Mailing Address - Fax:
Practice Address - Street 1:2037 UTICA AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-3215
Practice Address - Country:US
Practice Address - Phone:718-377-6856
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-26
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0381871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical