Individual provider Active NPI

Lisa M Cruz, BA

  • Mental Health Counselor
  • Bremerton, WA
National Provider Identifier
1831235613
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
RC00037459 Issued in WA
Practice address
5455 Almira Dr SE
Bremerton, WA 98311-8330
Phone
(360) 373-5031
NPI assigned
Jan 29, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X RC00037459 WA Primary

Addresses

Primary practice location

5455 Almira Dr SE
Bremerton, WA 98311-8330

Mailing address

5455 Almira Dr SE
Bremerton, WA 98311-8330
Phone (360) 373-5031

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • 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
I20240119003598 WA Practitioner - Mental Health Counselor 1951753441 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Arts

State licenses

LicenseStateTypeSpecialty
RC00037459WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Peninsula Community Health Services CurrentSince Jan 1, 2024 Accepting new patients
Peninsula Community Health Services CurrentSince Jan 1, 2024 Accepting new patients
Peninsula Community Health Services Current Accepting new patients
Peninsula Community Health Services PastSince May 16, 2021 Accepting new patients
Peninsula Community Health Services Past Accepting new patients
Peninsula Community Health Services PastSince Apr 24, 2022 Accepting new patients

Locations

300 E Campus Dr
Belfair, WA 98528
Phone (360) 277-2302

31 NE State Route 300
Ste 200
Belfair, WA 98528
Phone (360) 377-3779

5455 Almira Dr NE
Bremerton, WA 98311
Phone (360) 373-5031

616 6th St
Bremerton, WA 98337
Phone (360) 478-2366

25989 Barber Cut Off Rd NE
Kingston, WA 98346
Phone (360) 297-2844

26201 Siyaya Ave NE
Rm 121
Kingston, WA 98346

2150 Fircrest Dr SE
Rm G1
Port Orchard, WA 98366

320 S Kitsap Blvd
Port Orchard, WA 98366
Phone (360) 876-7215

19917 7th Ave NE
Ste 205
Poulsbo, WA 98370
Phone (360) 697-7636

627 W Franklin St
Shelton, WA 98584
Phone (360) 427-8940

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831235613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5455 ALMIRA DR SE",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983118330",
            "telephone_number": "360-373-5031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5455 ALMIRA DR SE",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983118330",
            "telephone_number": "360-373-5031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ",
        "first_name": "LISA",
        "middle_name": "M",
        "credential": "BA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "RC00037459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bremerton, WA

Sources for this page

Verify at the official NPI Registry.