Justine Cruise-Roberson, MSW, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW61199358 Issued in WA

Practice address

805 West Bay Dr NW
Olympia, WA 98502-4839

Phone

(360) 524-3415

NPI assigned

Nov 8, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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": "1478563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672704000000",
    "number": "1124560180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 WEST BAY DR NW",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985024839",
            "telephone_number": "360-524-3415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 WEST BAY DR NW",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985024839",
            "telephone_number": "360-524-3415"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1901 Martin Luther King Jr Way S",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981444801",
            "country_code": "US",
            "telephone_number": "360-524-3415",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRUISE-ROBERSON",
        "first_name": "JUSTINE",
        "credential": "MSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-08",
        "last_updated": "2023-01-03",
        "certification_date": "2022-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW61199358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christian Crowell
• Tom Edwin Crowell, SOCIAL WORKER
• Larry Creston Crowley Jr., LICENSED MENTAL HEAL
• Yolanda Crowley
• Nicholas Crudo
• Raul Manuel Buenaflor Cruz, M.D.
• Riley Cruz, LMT
• Crysalis Counseling & Associates PLLC
• Megan Elizabeth Cuevas, ARNP, CPNP
• Leslie Michelle Cullen

• Clinical Social Worker in Olympia, WA
• Providers in Olympia, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2023; 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.