RAVEN CRUZ-HUMBERTO
NPI 1003445214
Counselor in Russellville, AR

Q: What is Raven Cruz-humberto's NPI number?

The NPI number for Raven Cruz-humberto is 1003445214. It was assigned to this individual provider in the NPPES registry on April 8, 2020.

Q: What is Raven Cruz-humberto's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

Active since April 08, 2020PECOS EnrolledAccepts Medicare Assignment

104 LOCK AND DAM RD, RUSSELLVILLE, AR 72802(479) 747-5222 Get Directions Write a Review

NPPES record last updated: July 15, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jul 15, 2026, Apr 8, 2020 (2 updates tracked since 2020).

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About Raven Cruz-humberto NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RAVEN CRUZ-HUMBERTO (NPI 1003445214) is an individual counselor in Russellville, Arkansas and active in the NPI registry since April 2020. She is enrolled in Medicare PECOS, maintains a secondary practice location in Russellville, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1003445214

Entity TypeIndividualFemale

Primary Taxonomy101Y00000X

Provider Legal NameRAVEN CRUZ-HUMBERTO

Location Address104 LOCK AND DAM RDRussellville, AR 72802-9725

Mailing Address1305 E Main StRussellville, AR 72801-5322 · (479) 222-1965

Phone(479) 747-5222

Sole ProprietorNo

Medical School CMSOtherGraduated 2020

Enumeration DateApril 8, 2020

Last NPPES UpdateJuly 15, 20262 updates tracked since enumeration

NPPES CertifiedJuly 15, 2026

✔ NPI 1003445214 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers

Taxonomy Code101Y00000X

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's degree and clinical experience and supervision for licensure or certification.

104 LOCK AND DAM RD, Russellville, AR 72802

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Secondary Practice Location 1

Location 11305 E Main StRussellville, AR 72801-5322 · Phone (479) 222-1965

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Raven Cruz-humberto is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9739697020

PECOS Enrollment IDI20250806003854

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Raven Cruz-humberto reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

River Valley Youth Foundation

Same address

Community/Behavioral Health

104 LOCK AND DAM RD
Russellville, AR 72802

Reassigned Medicare billing, Arkansas enrollment
10 clinicians in this Medicare group

NPI 1770261869 (479) 567-5280

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SEUMR LONG

Community/Behavioral Health