Individual provider Active NPI

Laura Cruz Fawzy, LCPC

  • Professional Counselor
  • Gaithersburg, MD
National Provider Identifier
1023303476
Registry record updated Mar 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LC9361 Issued in MD
Practice address
610 E Diamond Ave Ste 100a
Gaithersburg, MD 20877-5321
Phone
(301) 840-3200
Fax
(301) 840-1348
NPI assigned
Jun 14, 2011
Last updated
Mar 26, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LGP7068 MD
Professional Counselor 101YP2500X LC9361 MD Primary

Addresses

Primary practice location

610 E Diamond Ave Ste 100a
Gaithersburg, MD 20877-5321

Mailing address

1215 Ingraham St NW
Washington, DC 20011-3601
Phone (904) 219-0421

Other names 1

  • Laura Marie Cruz Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LC9361MDMDProfessional Counselor
LGP7068MDMDProfessional Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1308009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553558400000",
    "number": "1023303476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 INGRAHAM ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200113601",
            "telephone_number": "904-219-0421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 E DIAMOND AVE STE 100A",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208775321",
            "telephone_number": "301-840-3200",
            "fax_number": "301-840-1348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAWZY",
        "first_name": "LAURA",
        "middle_name": "CRUZ",
        "name_prefix": "Mrs.",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-14",
        "last_updated": "2019-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LGP7068",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC9361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "CRUZ",
            "middle_name": "MARIE",
            "credential": "MA, LGPC.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gaithersburg, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.