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General NPI Number Information
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NPI Number | 1376093062
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Entity Type | Individual
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Provider Name | LINNETTA DE LA CRUZ LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/06/2016
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Last Update Date | 02/14/2025
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Provider Practice Location Address
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Address Line | 125 E 23RD ST STE 403-2
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City | NEW YORK
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State | NY
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Zip | 10010-4511
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Country | US
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Telephone | 917-524-9667
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Fax |
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Provider Business Mailing Address
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Address Line | 418 BROADWAY STE R
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City | ALBANY
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State | NY
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Zip | 12207-2922
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Country | US
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Telephone | 917-524-9667
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TP2701X
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Taxonomy Name | Group Psychotherapy Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 091477
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License Number State | NY
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