Marlene Wanton Cruz I, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

071473 Issued in NY

Practice address

9114 70TH Ave
Forest Hills, NY 11375-5825

Phone

(717) 261-6390

NPI assigned

Feb 27, 2019

Last updated

Feb 27, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Marlene Wanton Cruz I Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1551225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551225600000",
    "number": "1093272957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9114 70TH AVE",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113755825",
            "telephone_number": "717-261-6390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9114 70TH AVE",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113755825",
            "telephone_number": "717-261-6390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ",
        "first_name": "MARLENE",
        "middle_name": "WANTON",
        "name_suffix": "I",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-27",
        "last_updated": "2019-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "071473",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "071473",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0-71473",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARLENE",
            "last_name": "CRUZ",
            "middle_name": "WANTON",
            "suffix": "I",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jessenia Cruz- Garcia
• Alexandra Cruz, BACHELOR'S
• Gabriela Cruz
• Jesl Xena Rae Lizardo Cruz
• Margarita Elizabeth Cruz, LCSW
• Sholunda Cruz
• Tatiana Marie Cruz
• Tristan Cruz
• Van Gabriel S Cruz, PT, DPT
• Denisse Elizabeth Cuanetl

• Clinical Social Worker in Forest Hills, NY
• Providers in Forest Hills, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 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.