Provider Demographics
NPI:1922786300
Name:CRUZ, MELISSA ANN (LPC ASSOCIATE)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANN
Last Name:CRUZ
Suffix:
Gender:F
Credentials:LPC ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2610 TRAILMONT DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78253-5188
Mailing Address - Country:US
Mailing Address - Phone:830-708-3941
Mailing Address - Fax:
Practice Address - Street 1:8607 WURZBACH RD BLDG V
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1281
Practice Address - Country:US
Practice Address - Phone:210-239-6056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-06
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX90884101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health