Jack Cruzan, LCSW CSAC is a
Social Worker - Clinical based in Kealakekua, Hawaii. Jack Cruzan is licensed to practice in Hawaii (license number 3904) and his current practice location is
81-6587 Mamalahoa Hwy, Suite C-203, Kealakekua, Hawaii. He can be reached at his office (for appointments etc.) via phone at
(808) 987-2451.
NPI number for Jack Cruzan is 1861802464 and his current mailing address is Po Box 928, Captain Cook, Hawaii. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1861802464.
Healthcare Provider's Profile
| Full Name | Jack Cruzan |
|---|
| Gender | Male |
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| Speciality | Social Worker - Clinical |
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| Location | 81-6587 Mamalahoa Hwy, Kealakekua, Hawaii |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1861802464
- Provider Enumeration Date: 05/05/2014
- Last Update Date: 05/05/2014
Medical Identifiers
Medical identifiers for Jack Cruzan such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1861802464 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 1663-12 (Hawaii) | Secondary |
| 1041C0700X | Social Worker - Clinical | 3904 (Hawaii) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jack Cruzan is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Jack Cruzan, LCSW CSAC
Po Box 928,
Captain Cook, HI 96704-0928
Ph: () - | Jack Cruzan, LCSW CSAC
81-6587 Mamalahoa Hwy, Suite C-203,
Kealakekua, HI 96750
Ph: (808) 987-2451 |
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