Active NPI
Elizabeth Cruise, LCSW
- Clinical Social Worker
- Roxboro, NY
National Provider Identifier
1700826989
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- C001153
- Practice address
- 355-C Madison Blvd
Roxboro, NY 27573 - Phone
- (336) 599-8366
- NPI assigned
- Jun 7, 2006
- Last updated
- Dec 11, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | C001153 | NC | Primary |
Addresses
Primary practice location
355-C Madison Blvd
Roxboro, NY 27573
Mailing address
1415 W NC Highway 54
Suite 101
Durham, NC 27707-5577
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6106027 | Medicaid | NC |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C001153 | NC | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1228953600000",
"number": "1700826989",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1415 W NC HIGHWAY 54",
"address_2": "SUITE 101",
"city": "DURHAM",
"state": "NC",
"postal_code": "277075577"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "355-C MADISON BLVD",
"city": "ROXBORO",
"state": "NY",
"postal_code": "27573",
"telephone_number": "336-599-8366"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRUISE",
"first_name": "ELIZABETH",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-07",
"last_updated": "2008-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "C001153",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6106027",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.