Provider Demographics
NPI:1366865750
Name:CRUZ, PATRICIA RUTH (LCSW, DSW)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:RUTH
Last Name:CRUZ
Suffix:
Gender:F
Credentials:LCSW, DSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4905 ASHLEY PARK LN STE 28210
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-3656
Mailing Address - Country:US
Mailing Address - Phone:803-260-6520
Mailing Address - Fax:
Practice Address - Street 1:7400 CARMEL EXECUTIVE PARK DR STE 155
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-8242
Practice Address - Country:US
Practice Address - Phone:803-260-6520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-22
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSC94231041C0700X
NCC0164161041C0700X
SC9351104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker