Healthcare Provider Details

I. General information

NPI: 1043883390
Provider Name (Legal Business Name): XIOMARA CRUZ MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2021
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 W CENTRAL ST STE 25
NATICK MA
01760-3758
US

IV. Provider business mailing address

87 HAMILTON ST APT 2
WORCESTER MA
01604-2255
US

V. Phone/Fax

Practice location:
  • Phone: 508-653-4820
  • Fax:
Mailing address:
  • Phone: 787-515-3733
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: