Provider Demographics
NPI:1780801209
Name:CRUZ, MARGARITA ELIZABETH (LCSW)
Entity type:Individual
Prefix:
First Name:MARGARITA
Middle Name:ELIZABETH
Last Name:CRUZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6738 108TH ST APT B61
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-7935
Mailing Address - Country:US
Mailing Address - Phone:718-490-8903
Mailing Address - Fax:
Practice Address - Street 1:11011 QUEENS BLVD STE 1CC
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-5438
Practice Address - Country:US
Practice Address - Phone:718-490-8903
Practice Address - Fax:718-490-8903
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY069699-1104100000X
NY0761331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker