Provider Demographics
NPI:1770054140
Name:CRUZ-OLIVERA, ROCIO (MA, LPC,ACS)
Entity type:Individual
Prefix:MRS
First Name:ROCIO
Middle Name:
Last Name:CRUZ-OLIVERA
Suffix:
Gender:F
Credentials:MA, LPC,ACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 COLUMBIA AVE
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07307-4134
Mailing Address - Country:US
Mailing Address - Phone:201-344-6907
Mailing Address - Fax:
Practice Address - Street 1:116 COLUMBIA AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07307-4134
Practice Address - Country:US
Practice Address - Phone:201-344-6907
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-11
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00349900101YP2500X
NJ37PC00743800101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional