Provider Demographics
NPI:1467245076
Name:CRUZ, DIANA (LGPC)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:CRUZ
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7933 ANNAPOLIS RD # 1054
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-1309
Mailing Address - Country:US
Mailing Address - Phone:410-705-4422
Mailing Address - Fax:205-855-0617
Practice Address - Street 1:7933 ANNAPOLIS RD # 1054
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-1309
Practice Address - Country:US
Practice Address - Phone:410-705-4422
Practice Address - Fax:205-855-0617
Is Sole Proprietor?:No
Enumeration Date:2025-05-27
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP16416101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health