Basic Information
| Provider Information | |||||||||
| NPI: | 1508978065 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CRUISE | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | CHRISTOPHER | ||||||||
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| Credential: | PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 34 SOUTHVIEW MDW | ||||||||
| Address2: | |||||||||
| City: | WHITTIER | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287896500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8284975251 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 100 TEPTAL TER | ||||||||
| Address2: | |||||||||
| City: | BRYSON CITY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287135479 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8284885752 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/31/2006 | ||||||||
| LastUpdateDate: | 07/09/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | 2588 | NC | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical | 103TA0400X | AD003644 | N | Behavioral Health & Social Service Providers | Psychologist | Addiction (Substance Use Disorder) |
No ID Information.