Provider Demographics
NPI:1316074941
Name:MRUZ, MICHAEL GUY (MSW LCSW ACSW)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:GUY
Last Name:MRUZ
Suffix:
Gender:M
Credentials:MSW LCSW ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 HARWOOD COURT
Mailing Address - Street 2:SUITE 301
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583
Mailing Address - Country:US
Mailing Address - Phone:914-722-4151
Mailing Address - Fax:914-725-4777
Practice Address - Street 1:14 HARWOOD COURT
Practice Address - Street 2:SUITE 301
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583
Practice Address - Country:US
Practice Address - Phone:914-722-4151
Practice Address - Fax:914-725-4777
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR034012-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN71131Medicare ID - Type Unspecified