Basic Information
| Provider Information | |||||||||
| NPI: | 1255777272 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MARTINEZ-CRUZ | ||||||||
| FirstName: | LUISA | ||||||||
| MiddleName: | F | ||||||||
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| Credential: | LMFT, LADC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7271 W CHARLESTON BLVD STE 180 | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891171684 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7027479499 | ||||||||
| FaxNumber: | 7029120298 | ||||||||
| Practice Location | |||||||||
| Address1: | 7271 W CHARLESTON BLVD STE 180 | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891171684 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7027479499 | ||||||||
| FaxNumber: | 7029120298 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/16/2013 | ||||||||
| LastUpdateDate: | 07/20/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/20/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | 01249 | NV | N | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 106H00000X | MI#0532 | NV | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.