Active NPI
Omar Lyn De la Cruz, PSYD
- Clinical Psychologist
- Muskegon, MI
National Provider Identifier
1770464935
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 071.011467
- Practice address
- 2734 E Apple Ave
Muskegon, MI 49442-4413 - Phone
- (231) 798-4445
- NPI assigned
- Sep 11, 2025
- Sex
- Male
- Sole proprietor
- Yes
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 Psychologist | 103TC0700X | 071.011467 | IL | Primary |
Addresses
Primary practice location
2734 E Apple Ave
Muskegon, MI 49442-4413
Mailing address
2734 E Apple Ave
Muskegon, MI 49442-4413
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
| License | State | Type | Specialty |
|---|---|---|---|
| 071.011467 | IL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1757548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1768262400000",
"number": "1770464935",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2734 E APPLE AVE",
"city": "MUSKEGON",
"state": "MI",
"postal_code": "494424413"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2734 E APPLE AVE",
"city": "MUSKEGON",
"state": "MI",
"postal_code": "494424413",
"telephone_number": "231-798-4445"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE LA CRUZ",
"first_name": "OMAR",
"middle_name": "LYN",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-09-11",
"last_updated": "2026-01-13",
"certification_date": "2026-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "071.011467",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Muskegon, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.