Provider Demographics
NPI:1487883997
Name:CRUZLMH, ANTONIO (LMHC)
Entity type:Individual
Prefix:
First Name:ANTONIO
Middle Name:
Last Name:CRUZLMH
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:263 SPRING HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-2502
Mailing Address - Country:US
Mailing Address - Phone:954-461-4282
Mailing Address - Fax:
Practice Address - Street 1:263 SPRING HOLLOW DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-2502
Practice Address - Country:US
Practice Address - Phone:954-461-4282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-06
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH8099101YM0800X
225400000X, 251B00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
No251B00000XAgenciesCase Management