Healthcare Provider Details

I. General information

NPI: 1598304016
Provider Name (Legal Business Name): ROBERT ALAN CRUZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ROBERT ALAN TUSCHL

II. Dates (important events)

Enumeration Date: 01/01/2020
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

516 INNOVATION DR
CHESAPEAKE VA
23320-3866
US

IV. Provider business mailing address

5226 INDIAN RIVER RD
VIRGINIA BEACH VA
23464-6179
US

V. Phone/Fax

Practice location:
  • Phone: 757-943-9555
  • Fax:
Mailing address:
  • Phone: 757-943-9555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0701016185
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: