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General NPI Number Information
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NPI Number | 1003480898
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Entity Type | Individual
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Provider Name | ROBERTO CRUZ LCSW
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Gender | Male
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Dates
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Enumeration Date | 05/17/2021
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Last Update Date | 04/16/2025
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Provider Practice Location Address
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Address Line | 5999 BURKE COMMONS RD
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City | BURKE
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State | VA
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Zip | 22015-2880
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Country | US
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Telephone | 703-249-7700
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Fax |
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Provider Business Mailing Address
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Address Line | 210 E FAIRFAX ST APT 412
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City | FALLS CHURCH
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State | VA
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Zip | 22046-2908
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Country | US
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Telephone | 202-375-5535
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LC200002913
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 32958
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904016645
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License Number State | VA
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