Jose Delacruz, CADC-II

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

478 Issued in GA

Practice address

1990 Old Parker Rd SE
Suite 100
Conyers, GA 30094-6239

Phone

(678) 913-3255

Fax

(404) 975-4376

NPI assigned

Feb 19, 2014

Last updated

Feb 19, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Atlanta Quality Care Solutions, LLC

  • Community/Behavioral Health Agency
  • Conyers, GA
  • NPI 1699119255
  NPD (past)

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

{
    "created_epoch": "1392768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392768000000",
    "number": "1750706313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742531",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302741345",
            "telephone_number": "678-913-3255",
            "fax_number": "404-975-4376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1990 OLD PARKER RD SE",
            "address_2": "SUITE 100",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300946239",
            "telephone_number": "678-913-3255",
            "fax_number": "404-975-4376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELACRUZ",
        "first_name": "JOSE",
        "credential": "CADC-II",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-02-19",
        "last_updated": "2014-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "GA",
            "license": "478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nader A Dbouk, MD
• DDP Nursing Services of Ga. Inc
• James Ransford De Give, MD
• Joann Smith Dean, MSW, BCC
• Elizabeth Dykes Degive, MD
• Meredith Delp, D.O.
• Shameka Demps
• Rose Denaut
• Dawn Renee Dennis, NP
• Natasha Dennis, RBT

• Addiction (Substance Use Disorder) Counselor in Conyers, GA
• Providers in Conyers, GA by specialty
• Addiction (Substance Use Disorder) Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2014; 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.