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General NPI Number Information
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NPI Number | 1942933494
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Entity Type | Individual
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Provider Name | LISA JUNE CRUZ LMSW
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Gender | Female
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Dates
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Enumeration Date | 07/01/2022
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Last Update Date | 12/04/2022
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Provider Practice Location Address
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Address Line | 135 S BROADWAY
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City | SARATOGA SPRINGS
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State | NY
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Zip | 12866-4532
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Country | US
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Telephone | 518-885-2225
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Fax |
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Provider Business Mailing Address
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Address Line | 16 TWILIGHT DR
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City | CLIFTON PARK
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State | NY
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Zip | 12065-2111
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Country | US
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Telephone | 518-506-0438
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 108636
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License Number State | NY
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