| Doctor Name: | AGUSTIN JOSEPH CRUZ |
| NPI Number: | 1982004503 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MPA, MS, LPC |
| License Number: | LPC007933 |
| Business Practice Address: | 2405 Bemiss Rd Valdosta, GA - 316021936 |
| Business Phone Number: | 2293332351 |
| Business Fax Number: | 2293332353 |
| Mailing Address: | 5067 Pearl Davis Rd, VALDOSTA |
| State: | GA |
| Postal Code: | 316056206 |
| Phone Number: | 2294128125 |
| Fax Number: | 2293332353 |
| NPI Enumeration Date: | 09/02/2014 |
| NPI Last Update Date: | 09/02/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | LPC007933 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | GA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |