Individual provider Active NPI

Vanessa Cruz

  • Counselor
  • Cartersville, GA
National Provider Identifier
1144695859
Registry record updated Jun 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
178.011390 Issued in IL
Practice address
21 Wexford Cir NW
Cartersville, GA 30121-4761
Phone
(773) 575-2702
NPI assigned
Dec 7, 2015
Last updated
Jun 7, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 178.011390 IL Primary

Addresses

Primary practice location

21 Wexford Cir NW
Cartersville, GA 30121-4761

Mailing address

21 Wexford Cir NW
Cartersville, GA 30121-4761
Phone (773) 575-2702

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
178.011390ILMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Remedy Counseling CurrentSince Jun 15, 2021 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1449446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623024000000",
    "number": "1144695859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 WEXFORD CIR NW",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301214761",
            "telephone_number": "773-575-2702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 WEXFORD CIR NW",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301214761",
            "telephone_number": "773-575-2702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ",
        "first_name": "VANESSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-07",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "178.011390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cartersville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2021; 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.