Individual provider Active NPI

Juan Jose Santacruz

  • Addiction (Substance Use Disorder) Counselor
  • Albany, NY
National Provider Identifier
1295091114
Registry record updated Apr 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
64 2ND Avenue
Albany, NY 12202
Phone
(518) 449-5170
Fax
(518) 598-0493
NPI assigned
Apr 4, 2012
Last updated
Apr 4, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X NU Primary

Addresses

Primary practice location

64 2ND Avenue
Albany, NY 12202

Mailing address

74 Edward Street
2ND Floor
Cohoes, NY 12047
Phone (518) 572-4298

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

NPI Registry JSON

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

{
    "created_epoch": "1333497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333497600000",
    "number": "1295091114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 EDWARD STREET",
            "address_2": "2ND FLOOR",
            "city": "COHOES",
            "state": "NY",
            "postal_code": "12047",
            "telephone_number": "518-572-4298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 2ND AVENUE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "12202",
            "telephone_number": "518-449-5170",
            "fax_number": "518-598-0493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTACRUZ",
        "first_name": "JUAN",
        "middle_name": "JOSE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-04",
        "last_updated": "2012-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2012; 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.