Provider Demographics
NPI:1982235545
Name:CRUZ, NAOMI EVE (LCDC, LPC-INTERN)
Entity Type:Individual
Prefix:MS
First Name:NAOMI
Middle Name:EVE
Last Name:CRUZ
Suffix:
Gender:F
Credentials:LCDC, LPC-INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5769 BELT LINE RD APT 812
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75254-7676
Mailing Address - Country:US
Mailing Address - Phone:713-679-4378
Mailing Address - Fax:
Practice Address - Street 1:105 KATHRYN DR BLDG 3
Practice Address - Street 2:SUITE D
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-4216
Practice Address - Country:US
Practice Address - Phone:800-972-0643
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-31
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15201101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX15201OtherTEXAS STATE DEPARTMENT OF HEALTH SERVICES