Provider Demographics
NPI:1326762881
Name:CRUZ, EVA LETICIA (MS LPC)
Entity type:Individual
Prefix:
First Name:EVA
Middle Name:LETICIA
Last Name:CRUZ
Suffix:
Gender:
Credentials:MS LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4251 KIPLING ST UNIT 230
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-6835
Mailing Address - Country:US
Mailing Address - Phone:720-296-5853
Mailing Address - Fax:
Practice Address - Street 1:4251 KIPLING ST UNIT 230
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-6835
Practice Address - Country:US
Practice Address - Phone:720-296-5853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-28
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0021714101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX80249OtherLPC LICENSE