Provider Demographics
NPI:1245694009
Name:CRUZ, MARIA (LCSW)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:CRUZ
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7443 WASHINGTON ST
Mailing Address - Street 2:301
Mailing Address - City:FOREST PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60130
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7443 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:FOREST PARK
Practice Address - State:IL
Practice Address - Zip Code:60130-1549
Practice Address - Country:US
Practice Address - Phone:331-244-0956
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-07
Last Update Date:2025-02-21
Deactivation Date:2022-08-15
Deactivation Code:
Reactivation Date:2022-09-07
Provider Licenses
StateLicense IDTaxonomies
IL149.0230261041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical