Healthcare Provider Details

I. General information

NPI: 1588586853
Provider Name (Legal Business Name): MELANIE LYNN CRUZ LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 UNITY DR
BRICK NJ
08723-5461
US

IV. Provider business mailing address

20 UNITY DR
BRICK NJ
08723-5461
US

V. Phone/Fax

Practice location:
  • Phone: 732-688-5455
  • Fax:
Mailing address:
  • Phone: 732-688-5455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC06681700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: