Provider Demographics
NPI:1316452287
Name:CRUZ, BRITTANY N (MS, CAP, PPC)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:N
Last Name:CRUZ
Suffix:
Gender:F
Credentials:MS, CAP, PPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 S WILSON ST
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601-2941
Mailing Address - Country:US
Mailing Address - Phone:307-233-4195
Mailing Address - Fax:
Practice Address - Street 1:231 S WILSON ST
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-2941
Practice Address - Country:US
Practice Address - Phone:307-233-4195
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-13
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYPPC-1066101YP2500X
WYCAP-134101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional