Provider Demographics
NPI:1447709936
Name:DE LA CRUZ, SUMMER NICOLE (LICSW)
Entity type:Individual
Prefix:
First Name:SUMMER
Middle Name:NICOLE
Last Name:DE LA CRUZ
Suffix:
Gender:
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 SAXTON DR
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-6815
Mailing Address - Country:US
Mailing Address - Phone:571-263-6694
Mailing Address - Fax:
Practice Address - Street 1:1110 SAXTON DR
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-6815
Practice Address - Country:US
Practice Address - Phone:571-263-6694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-26
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500794331041C0700X
MD195971041C0700X
VA09040094501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical