Provider Demographics
NPI:1922596832
Name:CRUZ-AYALA, CHRISTIAN RAFAEL (LMHC)
Entity Type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:RAFAEL
Last Name:CRUZ-AYALA
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:CHRISTIAN
Other - Middle Name:RAFAEL
Other - Last Name:CRUZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CHRISTIAN CRUZ
Mailing Address - Street 1:31 JUNIPER TRAK
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34480-9570
Mailing Address - Country:US
Mailing Address - Phone:352-642-3661
Mailing Address - Fax:
Practice Address - Street 1:216 NE 1ST AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34470-6654
Practice Address - Country:US
Practice Address - Phone:352-732-6565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-26
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)