Provider Demographics
NPI:1952723868
Name:CRUZ, ANGELA C (LMFT, MS)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:C
Last Name:CRUZ
Suffix:
Gender:F
Credentials:LMFT, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:199 W HIGH ST
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-1817
Mailing Address - Country:US
Mailing Address - Phone:908-448-8083
Mailing Address - Fax:
Practice Address - Street 1:68 N BRIDGE ST
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08876-1919
Practice Address - Country:US
Practice Address - Phone:908-227-5815
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-11
Last Update Date:2019-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37FI00174400106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist