Active NPI
Stefanie Cruz
- Marriage & Family Therapist
- Portland, OR
National Provider Identifier
1982158333
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- T1819
- Practice address
- 2705 E Burnside St Ste 206
Portland, OR 97214-1768 - Phone
- (503) 453-4011
- NPI assigned
- Aug 14, 2016
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | T1819 | OR | Primary |
Addresses
Primary practice location
2705 E Burnside St Ste 206
Portland, OR 97214-1768
Mailing address
2705 E Burnside St Ste 206
Portland, OR 97214-1768
Phone (503) 453-4011
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 |
|---|---|---|---|
| T1819 | OR | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lifeworks NW | Mental Health | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1471132800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642982400000",
"number": "1982158333",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2705 E BURNSIDE ST STE 206",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972141768",
"telephone_number": "503-453-4011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2705 E BURNSIDE ST STE 206",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972141768",
"telephone_number": "503-453-4011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRUZ",
"first_name": "STEFANIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-08-14",
"last_updated": "2022-01-24",
"certification_date": "2022-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "OR",
"license": "T1819",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.