Provider Demographics
NPI:1801006895
Name:CRUCKSON, CARI S (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:CARI
Middle Name:S
Last Name:CRUCKSON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MISS
Other - First Name:CARI
Other - Middle Name:SUZANNE
Other - Last Name:SAVINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MFTI
Mailing Address - Street 1:1600 W CHANDLER BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-6100
Mailing Address - Country:US
Mailing Address - Phone:480-524-0990
Mailing Address - Fax:
Practice Address - Street 1:1600 W CHANDLER BLVD STE 110
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-6100
Practice Address - Country:US
Practice Address - Phone:490-524-0990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 48703106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMFC 48703OtherBOARD OF BEHAVIORAL SCIENCES
AZ15378OtherBOARD OF BEHAVIORAL HEALTH EXAMINERS