Healthcare Provider Details

I. General information

NPI: 1578944856
Provider Name (Legal Business Name): JESSICA LEANNE CRUZ LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JESSICA LEANNE KRAFT

II. Dates (important events)

Enumeration Date: 06/12/2015
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1595 LAKEVIEW AVE STE 9
DRACUT MA
01826-3353
US

IV. Provider business mailing address

1595 LAKEVIEW AVE STE 9
DRACUT MA
01826-3353
US

V. Phone/Fax

Practice location:
  • Phone: 978-455-2628
  • Fax: 978-746-9480
Mailing address:
  • Phone: 740-497-2911
  • 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:
Title or Position:
Credential:
Phone: