Provider Demographics
NPI:1659169647
Name:CRUZ HALL, VICTORIA J (BA, MSW, LLMSW)
Entity type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:J
Last Name:CRUZ HALL
Suffix:
Gender:
Credentials:BA, MSW, LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:279 S JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:COLDWATER
Mailing Address - State:MI
Mailing Address - Zip Code:49036-2212
Mailing Address - Country:US
Mailing Address - Phone:518-315-9743
Mailing Address - Fax:
Practice Address - Street 1:20 DIVISION ST
Practice Address - Street 2:
Practice Address - City:COLDWATER
Practice Address - State:MI
Practice Address - Zip Code:49036-1966
Practice Address - Country:US
Practice Address - Phone:518-315-9743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68511187051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty