Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Cory Blake Cruz, PPC

Individual provider Professional Counselor · NPI 1497391270

Cory Blake Cruz, PPC is a Mental Health Counselor in Casper, Wyoming. Qualified in 2019, 7 years ago. Practices with S48Wy1 LLC, a 4-clinician group and accepts Medicare assignment. Licensed in Wyoming.

Years since qualifying
7
Licensed in
WY
In the registry since
2019
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Practice location Address checks out

231 S Wilson St
Casper, WY 82601-2941
Phone: (307) 256-3791
Fax: (307) 265-4480
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence PPC-1161 (WY)

Record details

NPI number1497391270
Entity typeIndividual (Type 1)
GenderMale
Credentials PPC
Sole proprietorNo
NPI enumeratedNovember 26, 2019
Last updated in NPPESNovember 26, 2019

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice S48wy1 Llc — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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