Healthcare Provider Details

I. General information

NPI: 1902925464
Provider Name (Legal Business Name): MARIBEL CRUZ M.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 SUFFOLK ST
LOWELL MA
01854-3642
US

IV. Provider business mailing address

91 ACROPOLIS RD
LOWELL MA
01854-1301
US

V. Phone/Fax

Practice location:
  • Phone: 978-452-5155
  • Fax: 978-970-0713
Mailing address:
  • Phone: 978-452-9817
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number283
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1017862
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: