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General NPI Number Information
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NPI Number | 1932552668
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Entity Type | Individual
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Provider Name | MICHELLE CRUZ LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/18/2016
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Last Update Date | 12/30/2025
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Provider Practice Location Address
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Address Line | 450 W 22ND ST STE 158
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City | LOMBARD
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State | IL
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Zip | 60148-6014
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Country | US
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Telephone | 630-474-3900
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Fax |
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Provider Business Mailing Address
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Address Line | 4038 OAK TREE LN
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City | PLAINFIELD
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State | IL
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Zip | 60586-5015
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Country | US
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Telephone | 773-655-2246
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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 | SW12037
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License Number State | FL
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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 | 149016283
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License Number State | IL
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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 | SW12037
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License Number State | FL
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