MAXIMO DE LA CRUZ (NPI# 1043875248) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043875248 |
| Entity Type | Individual |
| Full Name | MAXIMO DE LA CRUZ |
| Credential | QMHP-A-MA |
| Practice Address |
1303 Florida Ave Woodbridge VA 22191-3620 |
| Practice Telephone | 5713982758 |
| Mailing Telephone | 5715720050 |
| Enumeration Date | 2019-05-03 |
| Last Update Date | 2019-05-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
3329 | VA | Ambulatory Health Care Facilities |
| Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
3329-05-001 | VA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | DL | A61348160 | 01 |
| Street Address |
1303 FLORIDA AVE |
| City | WOODBRIDGE |
| State | VA |
| Zip Code | 22191-3620 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366007460 | Absolute Mental Health Clinic LLC | Clinic/Center | 1303 Florida Ave, Woodbridge, VA 22191-3620 | 2019-05-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861021131 | Bailey Orthodontics Pllc | Dentist | 16446 Navigation Drive, Woodbridge, VA 22191 | 2020-04-07 |
| 1417589326 | Meseret Abate | Registered Nurse | 15608 William Bayliss Ct, Woodbridge, VA 22191 | 2020-02-08 |
| 1992279327 | Velocity Urgent Care, LLC | Clinic/Center | 16422 Navigation Dr, Woodbridge, VA 22191 | 2019-01-18 |
| 1821577263 | Maame Gyasiwah Banahene | Registered Nurse | 1812 Featherstone Rd, Woodbridge, VA 22191 | 2018-08-07 |
| 1235617507 | Yaw P. Baidoo | Nutritionist | 14960 Potomac Heights Pl Apt 503, Woodbridge, VA 22191 | 2018-07-30 |
| 1477048452 | Anahita Abazari | Optometrist | 14901 Potomac Town Pl, Suite 120, Woodbridge, VA 22191 | 2018-06-22 |
| 1619490661 | Misti S Gray | Nurse Practitioner | 2296 Optiz Blvd, Suite 440, About Women Ob/gyn, Woodbridge, VA 22191 | 2017-07-21 |
| 1568991974 | Patrice Whilby | Behavior Technician | 2264 York Drive Apt 302, Woodbridge, VA 22191 | 2017-06-08 |
| 1508395245 | Maria Theresa Lee | Registered Nurse | 2028b Opitz Blvd # 22191, Woodbridge, VA 22191 | 2017-06-07 |
| 1861943763 | A1 Home Care, LLC | Home Health | 13928 Jefferson Davis Hwy, Ste # C, Woodbridge, VA 22191 | 2016-10-17 |
| Find all providers in zip 22191 | ||||
| Taxonomy Code | 261QM0855X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adolescent and Children Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366007460 | Absolute Mental Health Clinic LLC | Clinic/Center | 1303 Florida Ave, Woodbridge, VA 22191-3620 | 2019-05-03 |
| 1740691443 | Total Family Solutions, LLC | Clinic/Center | 1 Woodbridge Ctr Ste 440, Woodbridge, NJ 07095-1171 | 2014-05-15 |
| 1215260492 | G&g Respite Services | Clinic/Center | 2810 Burrough Hill Ln, Woodbridge, VA 22191-5155 | 2009-09-06 |
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| 1659993731 | Sandstone Care Virginia, LLC | Clinic/Center | 11415 Isaac Newton Sq S, Reston, VA 20190-5005 | 2020-05-12 |
| 1306467147 | Shenandoah Creative Counseling for Children and Adolescents | Clinic/Center | 510 W Broad St Ste H, Waynesboro, VA 22980-4548 | 2020-05-04 |
| 1801449855 | Amazing Counseling LLC | Clinic/Center | 2428 Windy Pines Bnd, Virginia Beach, VA 23456-3954 | 2019-07-18 |
| 1912468190 | Village Therapeutic Mentoring Services LLC | Clinic/Center | 1 W Cary St, Richmond, VA 23220-5609 | 2019-03-28 |
| 1801375118 | Clementine Twin Lakes, LLC | Clinic/Center | 13215 Twin Lakes Dr, Clifton, VA 20124-1215 | 2018-08-08 |
| Find all providers with the same taxonomy | ||||
| City | WOODBRIDGE |
| Zip Code | 22191 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.