Provider Demographics
NPI:1881025120
Name:CRUZ, LAUREN (MSW, LSW)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:CRUZ
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 RTE 35 N
Mailing Address - Street 2:
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-4604
Mailing Address - Country:US
Mailing Address - Phone:732-869-2752
Mailing Address - Fax:
Practice Address - Street 1:402 RTE 35 N
Practice Address - Street 2:
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-4604
Practice Address - Country:US
Practice Address - Phone:732-869-2752
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-12
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05926800104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker