Provider Demographics
NPI:1124727938
Name:MORALES CRUZ, XAVIER ELIAS (CDP, CMDCP, CTP, BCC)
Entity type:Individual
Prefix:
First Name:XAVIER
Middle Name:ELIAS
Last Name:MORALES CRUZ
Suffix:
Gender:M
Credentials:CDP, CMDCP, CTP, BCC
Other - Prefix:
Other - First Name:XAVIER
Other - Middle Name:E
Other - Last Name:MORALES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CDP, CMDCP, CTP, BCC
Mailing Address - Street 1:996 LAUSMAN DR
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MI
Mailing Address - Zip Code:49085-3215
Mailing Address - Country:US
Mailing Address - Phone:269-363-2495
Mailing Address - Fax:
Practice Address - Street 1:711 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MI
Practice Address - Zip Code:49085-1241
Practice Address - Country:US
Practice Address - Phone:269-240-7788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-01
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty