Healthcare Provider Details

I. General information

NPI: 1770429979
Provider Name (Legal Business Name): ELIZABETH CRUZ COUNSELING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5412 N CLARK ST
CHICAGO IL
60640-1223
US

IV. Provider business mailing address

2501 CHATHAM RD STE R
SPRINGFIELD IL
62704-4188
US

V. Phone/Fax

Practice location:
  • Phone: 972-433-0208
  • Fax:
Mailing address:
  • Phone: 972-433-0208
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH CRUZ
Title or Position: OWNER
Credential: LCPC
Phone: 972-433-0208