Provider Demographics
NPI:1801006895
Name:CRUCKSON, CARI S (LMFT)
Entity type:Individual
Prefix:MRS
First Name:CARI
Middle Name:S
Last Name:CRUCKSON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MISS
Other - First Name:CARI
Other - Middle Name:SUZANNE
Other - Last Name:SAVINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MFTI
Mailing Address - Street 1:2266 S DOBSON RD SUITE 200
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202-6412
Mailing Address - Country:US
Mailing Address - Phone:480-769-9290
Mailing Address - Fax:
Practice Address - Street 1:2266 S DOBSON RD STE 200
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-6412
Practice Address - Country:US
Practice Address - Phone:480-769-9290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 48703106H00000X
AZ15378106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ15378OtherBOARD OF BEHAVIORAL HEALTH EXAMINERS
CAMFC 48703OtherBOARD OF BEHAVIORAL SCIENCES