Individual provider Active NPI

Ashley Moore Cruz, LPC

  • Professional Counselor
  • Suffolk, VA
National Provider Identifier
1689437691
Registry record updated Sep 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0701013267 Issued in VA
Practice address
1301 Bridgeport Way Apt 210
Suffolk, VA 23435-1971
Phone
(760) 751-9616
NPI assigned
Feb 1, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 0701013267 VA
Professional Counselor 101YP2500X 0701013267 VA Primary

Addresses

Primary practice location

1301 Bridgeport Way Apt 210
Suffolk, VA 23435-1971

Mailing address

3575 Bridge Rd Ste 8
PMB #260
Suffolk, VA 23435-3361
Phone (805) 630-9734

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240329000169 VA Practitioner - Mental Health Counselor 4688012495 Practice locations: Suffolk, VA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0701013267VAMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1706745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725235200000",
    "number": "1689437691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3575 BRIDGE RD STE 8",
            "address_2": "PMB #260",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234353361",
            "telephone_number": "805-630-9734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 BRIDGEPORT WAY APT 210",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234351971",
            "telephone_number": "760-751-9616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE CRUZ",
        "first_name": "ASHLEY",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-01",
        "last_updated": "2024-09-02",
        "certification_date": "2024-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701013267",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701013267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffolk, VA

Sources for this page

Verify at the official NPI Registry.