Provider Demographics
NPI:1194906628
Name:CRUZ, CYNTHIA M (LMHC, BCBA)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:M
Last Name:CRUZ
Suffix:
Gender:F
Credentials:LMHC, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11996 SW 97TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-2623
Mailing Address - Country:US
Mailing Address - Phone:305-905-8205
Mailing Address - Fax:
Practice Address - Street 1:11996 SW 97TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-2623
Practice Address - Country:US
Practice Address - Phone:305-905-8205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-27
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH6628101YM0800X
FL1-21-48558103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health