Agustin Joseph Cruz, MPA, MS, LPC
Counselor, Professional in North Chesterfield, VA. Individual provider (NPI-1).
NPI number1982004503
StatusActive
Last updated in NPPESFeb 7, 2017
Details
- NPI
- 1982004503
- Entity type
- Individual (NPI-1)
- Name
- Mr. Agustin Joseph Cruz
- Credential
- MPA, MS, LPC
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Sep 2, 2014
- Last updated
- Feb 7, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | 0701006356 | VA | Yes |
| 101YM0800X | Counselor, Mental Health | 0701006356 | VA | |
| 101Y00000X | Counselor | 0701006356 | VA | |
| 103K00000X | Behavior Analyst | 0701006356 | VA |
Practice location
7825 Midlothian Tpke Ste 203North Chesterfield, VA 23235-5247
Phone 229-412-8125
Mailing address
7825 Midlothian Tpke Ste 203North Chesterfield, VA 23235-5247
Phone 229-412-8125
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